Laparoscopic Gallbladder Surgery

Keyhole surgery has revolutionised gallstone treatment for patients suffering upper abdominal pains.

Gallstone disease is very common.  Gallstones can form in the gallbladder and they can give patients upper abdominal pains that sometimes radiate to the right shoulder blade.  This is called biliary colic.  Gallstones can lead to more worrying conditions such as cholecystitis (inflammation of the gallbladder), ascending cholangitis (inflammation of the bile duct) and pancreatitis (inflammation of the pancreas gland).  Gallstones are diagnosed with ultrasound scanning of the abdomen.  Most patients with symptomatic gallstones require removal of the gallbladder and this is most commonly done by laparoscopic or keyhole surgery.  The operation is called a laparoscopic cholecystectomy.  Sometimes the gallbladder is too diseased to remove with keyhole instruments and if this occurs the surgeon reverts to the traditional open surgery and finishes the operation using their hands through a large abdominal incision.  Occasionally patients can experience bloating after the operation or they can get intermittent loose motions which can respond to simple anti-diarrhoeal medication.  The gallbladder acts as a storage area for bile which helps with food and particularly fat digestion.  The gallbladder is not an essential organ and most patients do not notice any detrimental effects once their gallbladder is removed.  While they are waiting for their gallbladder surgery, patients should stick to a very low fat diet to keep biliary colic at bay but after the gallbladder is removed they can resume a normal diet.

No special preparations are required for keyhole gallbladder surgery.  If patients are otherwise fit and well and have someone to look after them at home then their operation can often be done as a daycase procedure.  Otherwise a one night hospital stay is required.  After the operation patients should not do any heavy lifting or heavy exercise for two weeks but light duties and walking are encouraged.  Patients should try to keep their wounds dry for 48 hours to enable a scab to form over the wound which is the best type of dressing.  Patients can wash and shower as normal after surgery but they should replace any wet dressings with dry ones in the first 48 hours.  After two weeks most keyhole surgery patients will be able to resume all normal activities.  If patients have had to have open surgery through a large incision then they may well have to stay in hospital for several days longer and their recovery time at home is lengthened up to eight weeks.  There is no strict rule on getting back to driving but you should be happy that you can do an emergency stop and slam down the brakes if a young child were to suddenly run in front of your car.  For many patients this means not driving for at least one week after surgery.  Hospital clinic follow up is not normally arranged after gallbladder surgery for NHS patients and they should present to their GP in the first instance if they are having any unforeseen difficulties.