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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Gall bladder stones

Gall bladder stones

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Gall stone surgery or Cholecystectomy is a surgical procedure wherein the gall bladder and gall stones are removed together.

 

Usually the gall baldder is reomoved along with the gall stones because if left behind it can cause recurrence of gall stones.         

Methods

  • Open method
  • Laparoscopic method

Open method

This is the conventional method wherein the surgeon removes the gallbladder through a single, large incision in the abdomen. Done under general anesthesia and surgery lasts for 1 to 2 hours.

Laparoscopic method

In this method the surgeon removes the gall bladder  through several small incisions in the abdomen. It is also done under general anasthesia and lasts for around 2 hours. Before the procedure one has to undergo intraoperative cholangiography to know the precise anatomy of bile ducts. It has the advantages over open method like decreased bleeding, decreased risk of infection and shortened hospital stay.

Indications

  • Cholelithiasis-Gallstones in the gallbladder
  • Choledocholithiasis-Gallstones in the bile duct
  • Cholecystitis-Gallbladder inflammation
  • Pancreatitis-Pancreas inflammation

Absolute indications of Open method over Laparoscopic method

  • Cholangitis
  • Peritonitis
  • Portal hypertension
  • Third trimester of pregnancy.
  • Major bleeding disorder or use of medicines to prevent blood clotting (blood thinners or anticoagulants).
  • Scar tissue from previous abdominal surgeries(because Scar tissue may make laparoscopic surgery more difficult)
  • Pulmonary diseases such as emphysema

 

Risks

Some of the rare complications of cholecystectomy include

  • Bleeding
  • Infection
  • Injury to nearby structures such as bile duct, liver and small intestine
  • Pneumonia
  • Pancreatitis
  • Bile leakage 

Sucess rate

Laparoscopic gallbladder surgery is safe and effective. Surgery gets rid of gall stones within the gall bladder while it does not remove stones in the common bile duct. There is a very rare risk of gallstones being formed in the common bile duct years after the gallbladder is removed.