Steps involved in gallstone removal surgery

Gallstones are hardened deposits of bile [digestive juice] that are formed in the gallbladder where bile is stored and released into the intestine. Bile is produced by the liver and helps in digestion and breaking down fats into fatty acids. The formation of gallstones is also called cholelithiasis. There are two types of gallstones, and they are cholesterol gallstones and pigment gallstones.

Most of the diagnosed gallstones are cholesterol gallstones that are yellowish-green in color. They are made up of cholesterol and make up to 80% whereas pigment gallstones make up to 20% of total gallstones. Pigment gallstones are small in size and can appear darker in color. They are made up of bilirubin. Cholesterol, bilirubin, and bile salts are waste products carried out by bile.

Surgical treatment options for gallstones:

You may suffer from gallstones that are either large or small. In case if you have gallstones and do not show any symptoms, your doctor can suggest watchful waiting along with a few lifestyle modifications and dietary changes. Once you start showing symptoms of gallstones, your doctor can recommend undergoing surgical procedures like open gallbladder removal surgery [open cholecystectomy] and laparoscopic gallbladder removal surgery [keyhole surgery].

Surgical treatments have lower chances of recurrence of gallstone compared to non-surgical treatment options like shock wave therapy [uses high-frequency sound waves to fragment the stones] and ERCP [an instrument is inserted through the endoscope to attempt removal of the stone]. Laparoscopic and open gallbladder removal surgeries are more effective than non-surgical techniques.

Steps involved in Open gallbladder removal surgery [Open cholecystectomy]:

• Before the surgery, you or your family members need to sign a consent form that permits the surgeon to proceed with the surgery.
• Once you are shifted to the surgery room, your anesthesiologist will sedate you using either general or local anesthesia.
• Later when you are asleep, your surgeon will make a large incision on the right side under the rib cage.
• Through this incision or cut, your surgeon can have a good visualization of the gallbladder. Then your surgeon will identify all the structures of the porta hepatis.
• The gallbladder will then be grasped with clamps and manipulated to facilitate the best visualization.
• Then the cystic duct is divided in between as it is the cystic artery. Later, the gallbladder will be removed from the gallbladder bed of the liver using either electrocautery or a harmonic scalpel.
• After removing the gallbladder, your surgeon will inspect the gallbladder bed to identify and address any bleeding or leakage of bile from the bile duct.
• Finally, the incisions on the abdomen will be stitched or closed in a standard multilayer fashion.

To recover completely from the open gallbladder removal surgery, you may take four [4] to six [6] weeks.

Steps involved in Laparoscopic gallbladder removal surgery [Keyhole surgery or laparoscopic cholecystectomy]:

• Like in open surgery, you will be given a consent form to sign it which permits your surgeon to proceed on with the surgery.
• Then, an anesthesiologist will sedate you using either general or local anesthesia.
• Once you are asleep, your surgeon will make a few small incisions or cuts in the abdominal region.
• Through one of these small cuts, your surgeon will use a laparoscope that has a tiny camera at one end to visualize the internal organs and to monitor the laparoscopic procedure.
• Once the gallbladder is located, it will be removed through the other incisions made on the abdomen with the help of the latest surgical instruments.

Laparoscopic cholecystectomy is preferred over open surgery as it involves less risk of infection, quick recovery, safe & effective, and few incisions or cuts.

Conclusion:

Gallbladder removal surgery is the best and effective way to treat any types of gallstones. You may suffer from either a single large gallstone or multiple tiny gallstones. In case you start showing symptoms, your doctor will recommend undergoing gallbladder removal surgery. If you don’t show any signs or symptoms of gallstones, then your doctor may suggest watchful waiting. Open gallbladder removal surgery and laparoscopic gallbladder removal surgery are mainly used by surgeons to treat and prevent the formation of gallstones. Before undergoing any surgical procedures to treat gallstones, discuss with your doctor about the benefits, risks, and complications that are associated with the specific surgery.