Laparoscopic gall bladder surgery

Gall bladder removal required a big incision below the right chest. After the open procedure, patients were in pain and at danger of infection, which increased hospital stay and cost. To avoid open surgery’s drawbacks, laparoscopic gall bladder surgery became the standard.

Indications for gall bladder surgery:

1. Symptomatic gall bladder stone
2. Infection of gall bladder secondary to stone
3. Stone in the bile duct
4. Early gall bladder cancer
5. Mucocele of gall bladder

Gall stones

Contraindications:

  • If the patient is not fit for general anesthesia.
  • Altered coagulation profile i.e. bleeding tendency due to other diseases or drugs.

Procedure:

It involves making four(sometimes three) small holes in the anterior abdominal wall(tummy). Abdomen is then inflated like a balloon with CO2 gas to make space. Gall bladder is identified and dissection is done at the clot’s triangle. Critical view of safety is achieved, cystic duct and cystic artery is identified separately and cut between clips. Gall bladder is then dissected out from its bed. Care is taken not to injure the liver. Hemostasis is achieved and the gall bladder is removed in an endophage & gall bladder sent for histopathology examination. Port site is closed and then skin is sutured.

Complications:

1. Infection
2. Bleeding
3. Injury to bile duct
4. Port site hernia

However the chances of complications are less when performed by a well trained surgeon. At the same time complications increase when surgery is performed in a complicated gall bladder disease or when it is performed in an emergency setting.

Post surgery care:

  • Usually patients are kept in a post operative recovery room for few hours and then shifted to the room. Patients are usually allowed to eat/drink after 6 hours from the time of surgery. They can walk as and when anaesthesia effect is weaned off. In most of the cases the patients can be discharged on the same day itself.
  • Patients can resume their daily routine activities from next day, patients who have desk job usually start their office work from next day. There are no restrictions in diet or travel. Usually patients are asked to avoid lifting heavy weights for a period of 4 weeks.
  • Patients are usually required to come for a follow-up after 5 days with histopathology report and also for suture removal.

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Chief of Surgical Gastroenterology,
SMC Bangalore
Consultant Minimal Access Surgery, Apollo Hospital, Bangalore
Our Services
Dr. Gautham SL

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