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Surgery to remove the gallbladder

Surgery to remove the gallbladder
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Cholecystectomy

Cholecystectomy is a surgical operation to remove the gallbladder, the purpose of which is to eliminate the source (reservoir) of infection, which becomes this hollow organ when pathological processes appear and develop in it.

A healthy gallbladder serves as a reservoir for bile in the body. It takes an active part in the digestive process, contracting when food enters the stomach and secretes into the intestines a certain portion of bile necessary for digestion and assimilation of food.

With the appearance of any pathologies in the biliary, a person begins to feel intense pain. In this case, not only the functionality of the entire biliary system, but also of the pancreas is also disturbed. Therefore cholecystectomy significantly improves the general condition of the patient, improves the quality of his life, and if certain rules in the diet, practically does not affect the digestive processes

Indications for surgery

There are a number of different gallbladder diseases that can only be treated by removing this organ. These include:

  • Acute or chronic form of cholecystitis. Without adequate treatment, this ailment can lead to serious consequences, up to and including lethality. Complications of cholecystitis: perforation of the bladder walls, necrosis, peritonitis (inflammation in the abdominal cavity of purulent nature), sepsis, abscess. And if the disease runs along with cholelithiasis - immediate surgical intervention is required. Removal of the affected organ is the only correct and effective way to recovery.
  • Choledocholithiasis. Usually noted in patients with already diagnosed cholelithiasis, leads to complications such as: duct obstruction, in which there is a violation of the process of bile outflow, inflammation of the ducts or cholangitis, biliary pancreatitis. Such a condition requires extensive surgery, when sanation and drainage of the ducts is performed, along with the removal of the gallbladder itself.
  • Cholesterosis. This disease is characterised by cholesterol deposits on the walls of this organ. If its course is accompanied by gallstone disease, then only surgery is indicated.
  • Calcinosis (deposits of calcareous character on the walls inside the cavity of the organ) is an absolute indication for surgery.
  • Gallbladder polyps. If polyps exceeding 10 mm in size are detected on ultrasound, surgical treatment (cholecystectomy) is indicated. In case of smaller polyps are strictly monitored and prescribed drug therapy.
  • Gallstone disease (both symptomatic and asymptomatic).
  • Functional disorder of the gallbladder (only in certain cases surgery is indicated, and only after a thorough full examination of the biliary system).

Contraindications

Contraindications for gallbladder removal surgery can be a number of different conditions and diseases. This type of surgery is not prescribed for low blood coagulation, oncological pathology, in general in the critical condition of the patient.

Cholecystectomy can be performed after proper treatment and recovery of the patient in cases of anatomical abnormalities, acute inflammation, widespread peritonitis, Mirizzi syndrome, between the first and third trimesters of pregnancy, scleroatrophic bladder, various infections and large peritoneal hernias.

Decisions on the feasibility of cholecystectomy are made jointly by two specialist doctors - a surgeon and an anaesthetist.

Types of cholecystectomy and preparation

To date, there are three technologies of cholecystectomy: laparoscopy, open mini-invasive, traditional.

It is the first option is considered the ‘gold standard’, applicable to the therapy of chronic and acute forms of cholecystitis. It is performed through several small (up to 10 mm) incisions that are made in the wall of the peritoneum. In them are introduced trocars (special tubes), in the cavity of the peritoneum pumped carbon dioxide, creating a sufficient volume of space there so that the doctor can freely work with tools. After isolating the anatomical elements, with the help of a video camera, the surgeon removes the gallbladder directly through one of the incisions, having previously separated it from the liver.

The main advantage of such an operation is minimal trauma to the abdominal wall and rapid healing, as well as the shortest period of full recovery of the patient.

Preparation for surgery consists of several stages. First, a complete medical examination of the patient is carried out (coagulogram, ultrasound, ECG, fluorography, esophagogastroduodenoscopy, colonoscopy), tests are taken. Sometimes requires MRI (magnetic resonance cholangiography), other procedures for a deeper study of the state of internal organs.

Then the patient is prescribed a week before the operation light diet. Immediately before the operation the last meal should be no later than 8-10 hours. And already in the hospital are preparatory procedures (cleansing the intestines, taking espumisan to minimise the risks of abdominal bloating), and so on.

The laparoscopic cholecystectomy itself can last from 20 minutes to two hours. It is performed under general anaesthesia.

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