(i) Symptomatic gallstones - Pain, nausea and vomiting from gallstones
(ii) Complications from gallstones - infection, pancreatitis, jaundice
(iii) Polyps/suspicion of cancer of gallbladder(eg porcelain gallbladder)
General anaesthesia. Usually 4 small cuts on abdomen. Telescope passed in. Carbon dioxide gas insufflation to lift abdominal wall up for view. Dissection to see gallbaldder and cystic duct and artery. Metal clips to gallbladder artery and cystic duct. X-ray of bile duct performed after dye is injected to exclude stones in bile duct(Operative cholangiogram) Drain tube at end of case.
Blood thinning injections usually at end of operation to prevent blood clot in the legs.
Postop - The nurse will ask you to frequently cough and take deep breaths as well as to move your legs while in bed. You should try to walk/sit out of bed several hours after the surgery. The drain tube is removed the following day if there is no bile leak. Discharge usually on the next day if able to mobilize comfortably and tolerate food.
Stone in bile duct - may need exploration of bile duct during operation or further surgery(ERCP)
Bile leak (1 in 200)/bile duct injury(1 in 230) - may need reoperation
Spillage of stones out of gallbladder
Need for open surgery(1 in 20) - especially if acutely inflammed
Bleeding and haematoma
Injury to bowel, blood vessel and other organs, adhesions
Wound infection, scar or keloid, hernia at port site
Heart attack, stroke, anaesthetic reactions, chest infections, blood clots in legs/lungs, death
Postop abdominal distension, gas pain in shoulder, loose bowel action/diarrhoea. Persisting symptoms despite surgery
Oral dissolution therapy - risks of gallstones recurring/poor outcome for large gallstones
Cholecystostomy - removing the stones alone : usually in patients who are too sick for the whole surgery to remove the gallbladder
Lithotripsy - shattering the stones smaller but this may cause more symptoms/complications
Operative Cholangiogram - X-ray of the bile duct with contrast