Laparoscopic gallbladder removal
Laparoscopic gallbladder surgery is one of the most common surgical procedures.
Currently, in most cases cholecystectomy is performed through small incisions with a laparoscope. In medical terminology this operation is referred to as laparoscopic cholecystectomy. The traditional surgery may be necessary very seldom.
- Preventing gallstone colic and possible post-op complications;
- Laparoscopic procedure can be performed through small 1-1.5cm incisions instead of big incisions which are normally 10-15cm long;
- You may feel only insignificant painful ailments following cholecystectomy;
- You are likely to return to your normal daily routine much sooner than after traditional surgery;
- In most cases the patient may leave hospital on the second day following the procedure.
Eligibility for a surgery is usually determined during a surgical consultation appointment and on the basis an ultrasound of the belly. Patients suffering from other diseases may require opinions of other specialists.
Stanisław Molski, MD. PhD. DSc.
Michal Molski, MD. PhD.
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Price list, refunds provided by insurance companies:
- Cost of verifying a patient’s eligibility for the procedure with a abdominal USG scan is 120 €;
- Cost of laparoscopic cholecystectomy amounts to 1700 €;
- Follow-up appointments up to 4 weeks following the surgery – free of charge.
What is the gallbladder?
- The gallbladder is a pear-shaped organ that sits just beneath the liver. The main function of the gallbladder is to store bile, or gall, which is produced by the liver and during this storage bile becomes more concentrated. Then bile is released through narrow ducts (bile ducts) into the small intestine where it plays a significant role in the process of digestion.
- In most adults, little bile acid crystals form in bile with time, the so called gall stones. The gall stones may block the bile inflow leading to painful ailments called biliary colic or a more advanced condition, that is jaundice.
- More serious cholelithiasis complications include acute cholecystytis or acute inflammation of the pancreas. The removal of the gallbladder can prevent complications without disturbing the digestive system function.
Cholelithiasis symptoms and indications for surgery
- Symptoms given by the gallbladder are usually caused by deposits, that is stones consisting of cholesterol and bile acids, which form in the gallbladder and bile ducts;
- There are no effective preventive measures against gall stones;
- The gall stones may block the bile release from the gallbladder leading to painful ailments, jaundice and even such serious complications as acute cholecystytis or acute inflammation of the pancreas;
- The main and most commonly performed examination to diagnose cholelithiasisis anultrasound of the belly. In other more complicated cases some additional imaging examinations are conducted.
Treatment methods for gallstones
- There are no effective and durable methods of dissolving or preventing the formation of gallstones;
- Diastolic medications are most frequently effective in case of cholelithiasis. To prevent colic attacks in patients with cholelithiasis, you are recommended to avoid fatty foods;
- The surgical removal of the gallbladder (cholecystectomy) appears to be the most effective treatment method for gallstones and the best way to prevent complications.
When you go to hospital you should take:
- Your ID document;
- So-far medical documentation;
- Pyjamas, toiletries, towel, mobile phone;
- If you suffer from other chronic diseases you should provide a specialist’s opinion that there are no contraindications for performing the procedure;
- List of medications used – fill out the form attached thereto please;
- Permanent medications (for arterial hypertension, insulin, for asthma and others);
- Certificate of hepatitis immunisation;
- Results of the following tests:
- Blood cell count including platelet count,
- Antibody to HBsAg result, antibody to HCV result,
- APTT, INR,
- blood group test,
- creatinine blood test,
- electrocardiogram description(for patients over 30 or those with heart diseases),
- chest X-ray,
- other tests (if they were ordered by your surgeon or anaesthesiologist).
If you take blood thinners or anticoagulants, you should suspend them for the period of seven days before the surgery upon consultation with your surgeon or general practitioner.
On the day of the surgery:
- You are advised to have a shower one day before cholecystectomy;
- Take your permanent medications with a little of water in the morning;
- If you use insulin or antidiabetic medicines ask your surgeon or anaesthesiologist in this regard;
- Remain on an empty stomach 5 hours before getting to hospital;
- Arrange relevant care you will need at home after the surgery.
Course of the procedure:
- The surgery is performed under general anaesthesia and it requires an intubation and drug-induced muscle relaxation;
- The surgeon inserts the laparoscopic camera through tiny incisions made around the umbilicus into the patient’s abdominal cavity;
- The laparoscope, which is an instrument with video lens at its tip, provides the surgeon with a magnified view of the patient’s internal organs in the abdominal cavity on a television screen;
- Through other incisions there are inserted surgical instruments into the abdominal cave that allow your surgeon to separate the gallbladder from its attachments and the remove it;
- After the gallbladder is removed from the abdomen the small incisions are closed with stitches and provided with dressings;
- The procedure normally takes about 60 minutes.
What can you expect after cholecystectomy procedure?
- You may expect nausea and vomiting caused by general anaesthesia following the procedure;
- Post-op pain is released with intravenous and then oral medication;
- You will be encouraged to get up and walk as soon as possible (usually only a few hours after the procedure);
- When nausea stops, you will be given drinks and food;
- Your wounds will be disinfected and the dressings will be changed once or twice on a daily basis;
- Once you are in a good condition and a diet is tolerated, you can leave the hospital with someone who takes care of you;
- You are allowed to have a shower provided that your wounds are covered and prevented from water access;
- You will probably be able to get back to normal activities within a week’s time;
- Most patients may return to work after two to three weeks following the procedure and this often depends on the nature of your job and how well you recover;
- After cholecystectomy procedure the fatty foods are normally not tolerated. Therefore, you should have small portions of lean food. After a while your digestive system gets used to the new condition allowing you to enjoy the dishes you had had before the procedure;
- The development of fever, yellow skin or eyes (sclera), worsening abdominal pain, distension, persistent nausea or vomiting, or drainage from the incisions are indications that you should contact your surgeon under these circumstances.
When should You consult a doctor after the procedure?
- Fever above 39oC;
- Yellow skin or eyes (sclera);
- Worsening abdominal pain and distension;
- Persistent pain which does not release after taking analgesics;
- Persistent nausea or vomiting;
- Chronic cough or shortness of breath (dyspnoea);
- Drainage from the post-op incisions;
- Worsening redness around post-op incisions;
- Drinking or eating problems.
The risks of laparoscopic gallbladder surgery:
- Infection, abscess;
- Post-op wound hernia;
- Hypertrophied scar or keloid;
- Perforation of the alimentary tract;
- Pneumothorax, pneumonia;
- Venous thromboembolism;
- Bile duct injuries;
- Adverse drug reaction.