Cholecystectomy Surgery - Uses, Indications & Cost

Cholecystectomy procedure is a surgical removal of the gall bladder. The gallbladder is a tiny organ under the liver on the upper right side of the abdomen. It stores a digestive juice called bile, produced by the liver, that helps digest foods.

Most cholecystectomy surgeries are performed to address symptoms caused by gallstones, like sudden abdominal pain (biliary colic), or to treat complications of gallstones, such as acute cholecystitis (swelling of the gallbladder) and biliary pancreatitis (pancreas inflammation). Sometimes, cholecystectomy surgeries are also performed when the gastro surgeon detects gallbladder issues while performing other abdominal operations.

Laparoscopic (keyhole) cholecystectomy is a minimally invasive procedure to remove a diseased gallbladder using a laparoscope. It is the "gold standard" for the surgical treatment of gallstone disease. Since the early 1990s, this method has largely replaced the traditional open approach for gallbladder removal.

It has many benefits, including less postoperative pain, shorter hospital stays, less invasive, and a quicker return to work after surgery. Usually, it treats patients who develop symptoms such as pain or complications from gallstones or when the person has gallbladder dyskinesia (when the gallbladder contracts abnormally (spasm) and does not empty properly).

Complications of cholecystectomy are rare. However, they can occur in some cases, which include:

• Bile duct injury
• Bleeding
• Bile leakage 
• Infection
• Hernia
• Adhesions (bands of scar tissue)

The common way of sealing (closing) the cystic duct in laparoscopic cholecystectomy is done using titanium non-absorbable metal clips (>80%). Even though bile leakage occurs in about 0.4% to 2.0% of cholecystectomy surgeries.

These clips will help to seal off blood vessels and close the cystic duct and artery, which can lead to the prevention of bleeding and bile leakage. These materials are safe for medical use in surgical procedures. The gastro surgeon may decide the choice of clip. 

No, Cholecystectomy cannot cause weight gain. Because the gallbladder doesn't have a major function in digestion, removing the gallbladder will not change the patient's digestion or metabolism and will not cause weight gain.

It is a common misconception that people will gain weight after surgery. There are no studies to show that people will definitively gain weight after the removal of the gallbladder. Some patients who lose weight rapidly, such as after weight loss surgery, are at higher risk of having gallstones and gallbladder disease related to weight loss. Still, there is no risk of gaining weight after removing the gallbladder. Even if the patient has problems with the gallbladder due to gallstones, the gastro surgeon recommends that the patient's gallbladder be removed.

The common cause of post-cholecystectomy syndrome (PCS) is the presence of stones (calculi) in the common bile duct or cystic duct remnant (remaining part of the cystic duct). Other causes are thought to be caused by either organic or functional problems with the gastrointestinal tract. 

Post-cholecystectomy syndrome is a condition that can occur after gallbladder removal surgery. It is characterised by nausea, vomiting, heartburn, indigestion, diarrhoea, jaundice and fatty food intolerance.

One in 20 to 50 laparoscopic operations cannot be completed and must be changed to open operation. It involves the removal of laparoscopic instruments and a larger cut (10 - 15 cm long) in the abdomen. Reasons for switching to open operation include:

• Scarring of gallbladder or inflammation of gallbladder
• Unable to see vital organs clearly
• Adhesions from previous operations
• Excessive bleeding
• Severe obesity 
• Stones in the bile duct.

Post-cholecystectomy syndrome is a condition that can occur after the gallbladder removal surgery. It is characterised by nausea, vomiting, heartburn, indigestion, diarrhoea, jaundice and fatty food intolerance. The common cause of post-cholecystectomy syndrome (PCS) is the presence of stones (calculi) in the common bile duct or cystic duct remnant (remaining part of the cystic duct). Other causes are thought to be caused by either organic or functional problems with the gastrointestinal tract.

There are no strict restrictions on diet (food) after gallbladder removal. These are the foods that patients can have after the gallbladder removal:

• Drink plenty of fluids
• Warm water, green tea or lemon tea with almonds
• Limited amount of milk having less fat
• Have a proper Indian breakfast without ghee and butter.
• Use low-fat milk and curd
• Egg white, bowl of fruits, small bowl of low-fat curd
• Avoid fried, fatty and spicy foods
• Avoid alcohol after cholecystectomy.

Yes, Cholecystectomy is considered to be a safe procedure. However, like any surgery, there is a risk of complications, such as wound infection, blood clots, wound infection, bile leaking into the tummy and bleeding.

It is safe when performed by a board-certified, experienced gastro surgeon in an accredited facility with ICU and ventilator backup. So, it is recommended to always check the gastrosurgeon's credibility and hospital facility before getting the surgery.

After the removal, the patient's gallbladder is sent to the lab for analysis, where it will be carefully sliced and examined under a microscope to confirm the diagnosis and look for the presence of growths, which sometimes develop in the wall of the gallbladder. Patients can lead a perfectly normal life without a gallbladder. Still, the liver produces bile to digest food. However, it will drip continuously into the bowels instead of stored in the gallbladder. 

No, it is not a major surgery. Laparoscopic (keyhole) cholecystectomy is a minimally invasive procedure to remove a diseased gallbladder using a laparoscope. It is considered a low-risk or minor surgery compared to other major surgical procedures. Since the early 1990s, this method has largely replaced the traditional open approach for gallbladder removal. Laparoscopic cholecystectomy has many benefits, including less postoperative pain, shorter hospital stays, less invasive, and a quicker return to work after surgery.

Yes, Gallbladder removal is considered as safe. It is safe when performed by a board-certified, experienced gastro surgeon in an accredited facility with ICU and ventilator backup. So, it is recommended to always check the gastrosurgeon's credibility and hospital facility before getting the surgery. However, like any surgery, there is a risk of complications, such as wound infection, blood clots, wound infection, bile leaking into the tummy and bleeding.

Patients can lead a perfectly normal life without a gallbladder. Still, the liver produces bile to digest food. However, it will drip continuously into the bowels instead of stored in the gallbladder. Some people may experience indigestion, which is temporary and gets better by having a low-fat diet.

Gallstones are stone-like debris in the gallbladder. Gallbladder removal is often suggested when a person has gallstones because even if the gallstones are removed, there is a high chance of formation of more stones in future. Bile, a substance the liver produces to break down fat, is stored in the gall bladder. An imbalance in bile leads to gallstone formation, which can contribute to stone formation. Removal of the gallbladder can eradicate the possibility of gallstones in future.

Yes, gallstones will be removed without removing the gallbladder with Endoscopic retrograde cholangiopancreatography (ERCP), Extracorporeal Shock Wave Lithotripsy (ESWL), and Oral Medications.

Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that can be used to clear gallstones from the bile duct. Hence, the gallbladder is not removed during this process, so any stones in the gallbladder will stay unless they're removed using other surgical approaches. Extracorporeal Shock Wave Lithotripsy (ESWL) is a procedure that uses shock waves to break (smash) gallstones into tinier pieces, which helps to be more easily removed or treated with drugs. Oral medications will be used for people who have tiny gallstones and who don’t contain calcium.

Patients may experience some temporary side effects, that include:

• Painful, swollen and bruised wounds: Starts within a few days, painkillers such as paracetamol may help reduce the pain and discomfort.
• Pain in stomach and shoulders: Patients face these side effects due to the gas (CO2) used to inflate the abdomen, which should pass after a couple of days. Painkillers can be given to relieve pain and discomfort.
• Bloating, diarrhoea and flatulence: These side effects can last a few weeks. Eating high-fibre food such as vegetables, fruit, brown rice etc can help to firm up the stools.

All these side effects are completely normal and not a big concern. Consulting the gastro gastro surgeon is recommended if the patient is facing severe or persistent side effects.

Cholecystectomy (gall bladder removal) procedure time can depend on the type of procedure and specific circumstances of the process, such as patient age, overall health, etc. There are two primary methods for removing the gallbladder:

• The open cholecystectomy takes about 1 to 2 hours because it involves making a single large incision in the abdomen.
• Laparoscopic cholecystectomy takes 30 - 90 minutes and involves four small incisions, but it depends on the size and inflammation of the gallbladder.

No, Gallbladder surgery cannot cause Jaundice. Generally, Jaundice does not occur after Gallbladder surgery. However, if some stones stay after gallbladder surgery, it can cause bile duct blockages that cause extreme pain or Jaundice. This can occur as a side effect of Gallbladder surgery.

Jaundice after gallbladder removal surgery is not a common occurrence. However, if it does occur, the duration of jaundice can vary depending on the underlying cause. Jaundice can usually be seen prior to surgery, but it is very uncommon after the removal of the gallbladder. This can be due to various factors, like the presence of stones that remain after surgery or obstruction of the Hepatic bile duct, etc. It's important to consult your doctor if there is jaundice after surgery.

No, the gallbladder cannot grow back once it is completely removed. The cystic duct is also removed along with the gallbladder. The gallbladder is a tiny organ under the liver on the upper right side of the abdomen. It stores a digestive juice called bile, produced by the liver, that helps digest fatty foods. It is not a regenerative organ. Instead, the liver compensates for the missing organ and stores the bile. Patients can lead a perfectly normal life without a gallbladder. Still, the liver produces bile to digest food. It will drip continuously into the bowels instead of stored in the gallbladder.