Removal of Gallbladder by Laparoscopy

The Gallbladder is a small organ located under the liver. Its purpose is to store the extra bile produced by the liver, and secrete it to the small intestines, where the bile aids in the digestive process. The bile is a fluid and is composed of:

• Cholesterol
• Bile Salts
• Bilirubin (an orange-yellow pigment in the bile formed as a breakdown product of haemoglobin)

The bile thus helps digest the fat in the food that is consumed.

Gallstones that are formed in the gallbladder can happen due to several reasons, such as genetics, reduced motility in the gallbladder, diet and body weight. There are two types of gallstones:

• Cholesterol stones: In 80% of the cases, the gallstones are of this type. They are greenish yellow in colour. The cholesterol stones form when there is too much cholesterol in the bile. Another reason for cholesterol stone formation is attributed to the inability of the gallbladder to empty itself quickly.
• Pigment stones: Made of bilirubin, these stones are smaller in size and darker in colour. These stones are more common in people with certain medical conditions like cirrhosis of the liver, and blood disorders such as sickle cells or anaemia.

Risk factors for developing gallstones

• Hereditary factor: Anybody with a family history of gallstones is at risk.
• Uncontrolled weight/obesity: Being one of the biggest risk factors, obesity can cause rise in the cholesterol levels in the bile, which prevents the gallbladder from emptying itself.
• Estrogens: High levels of estrogens too can reduce motility in the gallbladder. Pregnant women and those who have undergone hormone replacement therapy are at greater risk.
• Gender and age: Women and elderly people are more prone to develop gallstones.
• Cholesterol Medications: A few types of cholesterol-lowering medications can increase the amount of cholesterol in the bile, thus increasing the possibility of developing gallstones.
• Weight Loss and Fasting: Losing weight rapidly causes increased levels of cholesterol formation in the bile, which in turn causes the development of gallstones. Fasting causes the gallbladder to contract less, thereby increasing the chances of gallstones formation.
• Diabetes: Diabetic people tend to have a higher level of triglycerides in their blood. This is a big risk factor for formation of gallstones.

The Procedure
Laparoscopic gallbladder removal surgery or cholecystectomy is a very safe and effective procedure. There are very low risks involved in this surgery.

The surgeon makes four small (keyhole size) openings in the abdomen. A laparoscope with a lighted scope attached to a camera is inserted into the incision closest to the belly button. The surgeon uses a video monitoring screen for guidance while inserting the surgical instruments through the remaining incisions, to remove the gallbladder. Prior to removing the gallbladder, a special X-ray procedure called intraoperative cholangiography may be performed to view the anatomy of the bile ducts.

Anaesthesia
General anaesthesia is administrated prior to the procedure.

Post Laparoscopic Surgery

• The recovery time is very quick. You may be required to stay in hospital for 3-4 days.
• The bile will flow directly from the liver to the small intestine and will not affect the digestive process.
• Some discomfort maybe there for a week, but 10 days (normally), after the procedure, you will be able to resume all normal activities.
• No special diet is required.

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