Gallbladder removal
| Normal anatomy |
|
The gallbladder is located in the abdomen, on the right side,
underneath the liver. The gallbladder stores bile produced by the
liver, and delivers it to the first part of the small intestine
(duodenum), where it aids in the digestion of fat. The cystic and
common bile ducts connect the gallbladder to the duodenum. Bile
passes through these ducts from the gallbladder to the
duodenum.
|
| Indications |
|
Gallbladder surgery is done to treat gallbladder disease, which
consists predominantly of the formation of gallstones in the
gallbladder (cholelithiasis) that can cause:
- Obstruction of the cystic duct leading to severe abdominal pain
(biliary colic)
- Infection or inflammation of the gallbladder
(cholecystitis)
- Blockage of the biliary duct leading to the duodenum (biliary
obstruction)
- Blockage of the duct leading from the pancreas to the duodenum
(pancreatitis)
In each case, removal of the gallbladder (cholecystectomy) is
indicated.
|
| Incision |
|
Most gallbladder surgery today is done using laparoscopic
surgical techniques, in which narrow instruments, including a
camera, are introduced into the abdomen through small incisions.
With the patient under anesthesia, the abdomen is inflated with
carbon dioxide. Next, a laparoscopic camera is inserted into the
abdomen near the umbilicus (navel). Instruments are inserted
through 2 more incisions. The gallbladder is found, the vessels and
tubes are cut, and the gallbladder is removed.
|
| Procedure |
|
If the gallbladder is extremely inflamed, infected, or has large
gallstones, the abdominal approach (open cholecystectomy) is
recommended. A small incision is made just below the rib cage on
the right side of the abdomen. The liver is moved to expose the
gallbladder. The vessels and tubes (cystic duct and artery) to and
from the gallbladder are cut, and the gallbladder is removed. The
tube (common bile duct) that drains the digestive fluid (bile) from
the liver to the small intestine (duodenum) is examined for
blockages or stones. A small flat tube may be left in for several
days to drain out fluids if there is inflammation or infection.
|
| Aftercare |
|
Most patients who undergo laparoscopic cholecystectomy can go
home the day of surgery or the next day and resume a normal diet
and activities immediately. Most patients who undergo open
cholecystectomy require 3 - 5 days of hospitalization and are able
to resume a normal diet after 1 week and normal activities after 4
- 6 weeks.
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Review Date: 6/8/2008
Reviewed By: Harvey Simon, MD, Editor-in-Chief; Associate Professor
of Medicine, Harvard Medical School; Physician, Massachusetts
General Hospital.
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