All you need to know about gallbladder surgery

Escrito por: Mr Jonathan Wilson
Publicado: | Actualizado: 14/08/2023
Editado por: Carlota Pano

During gallbladder surgery, the gallbladder is removed from its attachments to the liver and bile duct and is extracted from the body. The procedure is usually performed under general anaesthesia with laparoscopic (keyhole) surgery, either as a day-case procedure or sometimes as an overnight stay.

 

Here to provide an expert insight into gallbladder surgery is Mr Jonathan Wilson, leading consultant in general and colorectal surgery based in London.

 

 

Why does a gallbladder need to be removed?

 

Once gallstones have started to form in the gallbladder, it is likely that the gallbladder is no longer functioning properly and therefore is not providing a physiological role anymore. The key decision when patients are first referred to the specialist is in determining whether the symptoms are really due to the stones, and not something unrelated such as peptic ulcer disease or irritable bowel syndrome (IBS).

 

Up to one out of three patients may have incidental gallstones found during an investigation, but in the majority of these patients, the stones will be innocent bystanders and the symptoms due to a separate pathology. However, if the symptoms are thought to be due to gallstones, and the stones and gallbladder are left there, they will continue to cause symptoms, which range from indigestion to severe upper abdominal pain, requiring hospitalisation. In their extreme, stones can cause pancreatitis which can be life-threatening.

 

What is the procedure during gallbladder surgery?

 

On average, 95 per cent of cases are done with laparoscopic surgery and using four tiny cuts, with the largest being 10mm. The gallbladder is freed from it its attachments from the liver and bile duct, and extracted in a bag via the umbilical (belly button) cut. This is either as a day-case procedure or sometimes an overnight stay, with a further one to two weeks off work recovering. 

 

In less than five per cent of cases, keyhole surgery is not enough and traditional 'open' surgery is necessary (only decided during the general anaesthetic) with a 10 - 15 cm cut below the right rib cage. This is much more painful to recover from and requires three to five days in hospital with another two to three weeks off work, so it's clear there is a big difference between keyhole and open surgery.

 

What’s life like post-operation?

 

Knowing which patients with gallstones will benefit from surgery is a key decision, and thus, excluding an alternative cause for pain is crucial. Clearly if the patient’s symptoms were actually due to indigestion, IBS or an alternative pathology, then their symptoms will remain post-operatively.



There is also a condition called Post-Cholecystectomy Syndrome (PCS) which describes a range of symptoms from abdominal pain, nausea/vomiting, change in bowel habit to looser stool, etc. It can affect 10 - 15 per cent of patients undergoing cholecystectomy (surgical removal of the gallbladder).

 

The symptoms can either be the original ones which have never gone away, usually because the gallstones were never genuinely responsible for the symptoms in the first place, or come on for the first time post-operatively as a consequence of surgery. Part of the consultation with a specialist will weigh up the risks versus benefit with the patient, whilst putting risks into real perspective.

Por Mr Jonathan Wilson
Coloproctología

El Sr. Jonathan Wilson es un consultor líder en cirugía general y colorrectal ubicado en la ciudad de Londres . Especializado en una amplia gama de tratamientos colorrectales y técnicas quirúrgicas, sus principales intereses se centran en todas las áreas de las enfermedades colorrectales, así como en las afecciones quirúrgicas generales, como las hernias de la pared abdominal de la ingle y los cálculos biliares .

Wilson es el médico clínico líder en servicios de cáncer colorrectal en Whittington NHS Trust y miembro de la junta de The (London Cancer) Colorectal Cancer Pathway Group, cuyo objetivo es mejorar todos los aspectos del manejo del cáncer colorrectal en pacientes del centro y noreste de Londres. En particular, recibió una beca del Royal College of Surgeons para completar una tesis doctoral que investiga las causas moleculares del cáncer de colon y recto.

Su práctica quirúrgica incluye técnicas mínimamente invasivas (cirugía laparoscópica) para hemorroides ( pilotes ), fisura anal , cáncer colorrectal , manejo quirúrgico de la enfermedad inflamatoria del intestino ( EII ; enfermedad de Crohn ; colitis lcerativa ), enfermedad diverticular y enfermedad pilonidal. El Sr. Wilson también se especializa en técnicas mínimamente invasivas para la hernia de la pared inguinal / abdominal y la enfermedad de la vesícula biliar.

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