Gallstone Surgery
Risk factors for developing gallstones
- Over 40 years old
- Female
- Family history
- Obesity and rapid weight loss
- Type 2 diabetes
Problems gallstones can cause
- Biliary colic – intermittent upper abdominal pain.
- Cholecystitis – constant pain localized to the right upper abdomen.
- Choledocholithiasis – stones in the bile duct.
- Cholangitis
- Pancreatitis
Diagnosis
- Blood tests- liver function test’s, full blood count and electrolytes
- Ultrasound
- MRCP- Magnetic Resonance Cholangiopancreatography
- CT IVC- Computed Tomography with intravenous cholangiogram
- HIDA scan- Hepatic Iminodiacetic Acid Scan (for functional gall bladder disorders)
How laparoscopic cholecystectomy is performed
- This operation is performed under a general anaesthetic with four keyhole cuts being made in the upper abdomen.
- The gall bladder is retracted up and away from the duodenum
- A dissection is carried out defining the biliary anatomy and a cholangiogram performed- this involves taking a series of x-rays as dye is injected into the biliary system clips are then placed on the cystic duct and artery before they are divided.
- The gall bladder is dissected off the liver, placed in a bag and extracted from the abdomen.
- The abdominal wounds are then closed with dissolvable sutures and dressings applied.
Post-operative diet and recovery
- All patients are commenced on a normal diet the same day of surgery.
- Most patients can be medically cleared to go home the same day however it is entirely reasonable if a patient wishes to stay overnight in hospital.
- For people who work in an office, one week off is usually all that is required.
- Walking is encouraged from day one.
