Symptoms of Gallbladder Stones
  • Bouts of indigestion, nausea and bloating
  • Severe episodes of pain precipitated by eating fatty food
  • Infection in the gallbladder
  • Jaundice
  • Pancreatitis (inflammation of the pancreas)
When is Surgery needed on Gall bladder?
  • Gall stones that are causing symptoms or complications
  • Polyps in the gall bladder
  • Biliary dyskinesia
  • Porcelain Gall bladder
Gallbladder and Laparoscopic Cholecystectomy

The Gallbladder (GB) is a pear-shaped organ that lies in the underside of the liver. It produces bile that helps in digesting fats. Due to imbalances in the chemical composition of the bile, stones can form in the GB. Laparoscopic Cholecystectomy is a keyhole surgery conducted to remove the gall bladder.

About the Gallbladder
  • The Gallbladder (GB) is a pear-shaped organ that lies in the underside of the liver, in the right upper quadrant of the abdomen. It is connected by ducts (tubes) to the liver and the duodenum (intestine).
  • The liver produces bile (substance essential for digesting fats) which is stored by the GB. When food is eaten (especially greasy foods), the GB contracts and forces bile into the gut.
  • Occasionally, due to imbalances in the chemical composition of the bile, stones can form in the GB.
Symptoms of Gallbladder Stones

The majority of people will have no symptoms and hence will require no treatment for their gallstones. In others the stones can cause the following symptoms:

  1. Bouts of indigestion, nausea and bloating.
  2. Severe episodes of pain that may be precipitated by eating fatty food. The pain is caused by the stones blocking the exit of the gallbladder and preventing it from emptying.
  3. The stones can cause infection in the gallbladder and make you very ill. You might need hospital admission to treat the infection either by antibiotics or emergency surgery.
  4. Jaundice which is caused by stones migrating from the gall bladder (GB) and blocking the main drainage pipe of the liver.
  5. In some cases the gallstones can trigger pancreatitis (inflammation of the pancreas) which potentially can be a life-threatening condition.

If the gallbladder causes symptoms, the only management option is surgical removal of the gallbladder which can be performed laparoscopically (keyhole) in 99% of cases. This is to relieve symptoms and also to prevent major complications in the future.

When will I need Surgery on my Gall bladder?

The indications for surgery to remove the gall bladder (Laparoscopic
Cholecystectomy) are:

  1. Gall stones that are causing symptoms or complications.
  2. Polyps in the gall bladder after they reach a certain size as the risk of harbouring cancer cells increases with size of the polyp.
  3. Biliary Dyskinesia- A motility disorder of the Gall bladder that causes symptoms of pain.
  4. Porcelain Gall Bladder-This is caused by deposition of calcium in the gall bladder wall thus hardening it and raising the risk of cancer slightly.
Laparoscopic Cholecystectomy

Approximately four small holes (about 1-2cm) are made in the tummy wall. Through these, special long instruments are used to free up the gallbladder along with its stones from underneath the liver and completely remove it. This is viewed on a TV screen by a miniature camera inserted through one of the four keyholes. After the GB is removed, the surgeon may choose to check the bile ducts by X-ray for any migrated stones.

What happens if the operation cannot be performed or completed by the laparoscopic method?

In a small number of patients the laparoscopic method cannot be performed. Factors that may increase the possibility of choosing or converting to the “open” procedure may include a history of prior abdominal surgery causing dense scar tissue, inability to see organs or bleeding problems during the operation. The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation and is not a complication but good surgical judgment.

How long will I be in hospital?

Most patients will come into hospital on the day of their operation, and will be able to go home later the same day (day stay). If there is any issue with pain control or ability to pass urine, you may be kept in overnight.

What should I expect after surgery?
  1. Following the operation, you will be transferred to the recovery room where you will be monitored for 1-2 hours until you are fully awake.
  2. Once you are awake and able to walk, drink liquids, and urinate, you will be sent home.
  3. You can expect some soreness mostly during the first 24 to 48 hours.
  4. You are encouraged to be up and about the day after surgery.
  5. With laparoscopic cholecystectomy, you will probably be able to get back to your normal activities within a week to 10 days. These activities include showering, driving, walking upstairs, lifting, working and engaging in sexual intercourse.
  6. You can return to your normal diet as soon as you are ready.
What complications can occur?

It is one of the most common operations performed and chances of any complications arising are less than 5%.

  1. The primary complications of any operation are bleeding and infection, which are uncommon with laparoscopic cholecystectomy.
  2. There is a small risk to damage of surrounding structures within the body during the operation (bowel or major blood vessels).
  3. There can be some leakage of bile into the abdomen from the raw surface of the liver causing post-op collections and infection.
  4. The stones in the gallbladder can slip into the bile ducts draining the liver and cause post-op jaundice or pancreatitis.
  5. In roughly 1 in 500 cases the main duct draining the liver can be damaged necessitating major reconstructive surgery.
  6. Approximately 10% of cases might experience some diarrhoea or loose stools after eating fatty foods. This is due to the inability to give a boost of bile to help break down the fat. This will usually settles over time, except in most severe cases. This can be treated with replacement bile salt tablets.
What activities will I be able to do after my surgery?

You can return to normal physical and sexual activities when you feel comfortable. You can undertake gentle activities immediately after the operation if it feels comfortable to do so. You should gradually increase your level of activity, back to normal for you, over the next few weeks. If you experience an increase in pain it may be because you have done too much.