Laparoscopic Choleycystectomy (Gallbladder Removal)

The Gallbladder is an organ on the upper right side of the abdomen. It sits under the edge of the liver, and its job is to store bile, which it then squirts out into the intestine. The bile is produced by the liver, and it helps digest the fats we eat. Unfortunately, the bile in the gallbladder can sometimes precipitate salts, which can then turn into bile stones over time. Many people have gallstones, and this, in and of itself is not a problem. When symptoms of the stones develop, however, surgery to remove the gallbladder is necessary. The symptoms are pain, which is mostly a sharp pain under the right rib cage, but can radiate to the right flank, the right back, the mid back, or the right shoulder. The pains can be set off by fatty foods, or sometimes occur randomly.

When a patient presents to their doctor with this pain, or to the Emergency Room, blood tests and a sonogram are usually performed. The blood tests show elevations in substances which indicate a problem, and the sonogram confirms the stones in the gallbladder, otherwise known as Choleylithiasis. The stones tend to float around in the gallbladder until they get "stuck" in the outflow tract, or Cystic Duct, at which point the pain begins. The pain can be rather severe, as the gallbladder attempts to contract against the obstructed duct with the stone lodged in it.

As time progresses, the stone causes swelling to a point that the arterial inflow, the blood supply, to the gallbladder gets compromised, and the gallbladder literally begins to die, or become necrotic. This state, when the gallbladder is dying, is known as Choleycystitis, and the gallbladder needs to be removed. Preferably, the gallbladder, when it has stones and symptoms of pain begin, should be removed. Trying to remove a gallbladder with Acute Choleycystitis is a riskier maneuver.

Surgically removing the Gallbladder is known as Choleycystectomy, and this is usually performed laparoscopically. A camera scope is placed through belly button, and other instruments are placed in various positions in order to best dissect the gallbladder duct, and remove it off of the liver. Ultimately, the fluid, or bile, in the gallbladder is sucked out, as if one is removing water from a water balloon, and the gallbladder is then removed from the abdomen through the belly button port site.

The Laparoscopic Choleycystectomy is usually a straight-forward procedure, and takes about an hour, with the patient leaving the hospital the same day. There are cases, however, in which a skilled and veteran surgeon is preferred, as the anatomy of the biliary tract, of which the gallbladder is a part, is complicated, difficult to elucidate, or difficult to handle. A complication with this anatomy can have significant, and even life altering consequences. Experience in this area as a surgeon is vitally important.

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