General Surgery

Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is a procedure adopted to remove the gall bladder through the minimal surgical invasion method. It is also the most popular method of choice in removing the gall bladder in gall stones and other gall bladder conditions.

Indications of the Cholecystectomy

Cholelithiasis, commonly known as gall stones, which can be single or multiple or small or large calcium stones.

Causes of cholelithiasis are decreased bile acid pool, bacterial infections, bile stasis due to obesity, pregnancy or increased cholesterol levels in the blood and haemolytic anaemia. Most of the gall stones are asymptomatic, if present then gall stone colic and flatulent dyspepsia (impaired digestion). The complications includes cancer of gall bladder, inflammation of the gallbladder, obstructive jaundice, white bile, acute intestinal obstruction and acute pancreatitis.

Cholecystitis is acute bacterial inflammation of gall bladder with or without the stone. This can be both acute and chronic type.

It is mainly due to the presence of microbes such as E.coli, Streptococci, Salmonella etc., and other causes include Typhoid fever, Clostridia infections and bile stasis.Symptoms of gall bladder infection includes sudden, intense pain on upper abdomen) region.

Diagnosis

Both the gall stones and gall bladder inflammation can be diagnosed by the history of symptoms, physical examination, complete blood investigations, X-ray, ultrasonography and HIDA scan.

Treatment

Conservative methods of treatment such as suction, antispasmodics and broad spectrum antibiotics are given, if the symptoms does not subside then cholecystectomy procedure is opted.

Laparoscopic cholecystectomy is considered the most standard form, as other old traditional form open cholecystectomy can lead to many complications such as postcholecystectomy syndrome and bile duct injury.

Procedure of the Laparoscopic Cholecystectomy

The procedure is done under the general anesthesia, area is cleaned and sterilized before the procedure. Then incision is done below the umbilicus through which a pneumoperitoneum is maintained by CO2 insufflation. Then a laparoscope is introduced with an attached camera and the incisions are made on the marked areas. Now cystic duct and cystic artery are clipped and separated and gall bladder is removed by the forceps. And the bleeding from the liver is controlled by lasers or electrocauterization.

Advantages

  • Faster recovery period.
  • Pain is minimal at the operated site and hence the movements of the body are easy and less painful.
  • Injury to the tissues and the other organs are unlikely.
  • It is most acceptable as the scar is minimal and adds to the cosmetic benefits.
  • Complications such as adhesions and the incisional hernia chances are rare.

In most of the cases, after the surgical procedure, the gall bladder is further sent to the histopathological examination to rule out any chances of cancer.


Hernia Surgery
laparoscopic cholecystectomy
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