Laparoscopic Cholecystectomy
Gallbladder Disease
Gallstones
An estimated 16 to 20 million people in the United States have gallstones. Gallstones are more common in females than males. Heredity, pregnancy and rare blood disorders (such as sickle cell disease) increase the risk of gallstone formation. About half of the people with gallstones have no symptoms and require no treatment.
Effects on Those With Diabetes
All diabetics, and those with symptoms (intermittent bloating, belching, abdominal pain after meals, fever, jaundice or pancreatitis), should be treated because of the high incidence of complications in these patients.
Treatment
Traditionally, treatment has been surgical removal of the gallbladder and gallstones (cholecystectomy). This procedure can be performed laparoscopically, which is a much less painful and less invasive procedure that offers a significantly reduced recovery time when compared to the procedure being performed open. Most patients are out of the hospital in less than a day and back to work within the week.
Technique of Laparoscopic Cholecystectomy
The operation is frequently done as an outpatient procedure. Under general anesthesia, gas is introduced into the abdominal cavity to provide room to see and work. Four pencil sized instruments are introduced through the abdominal wall. The gallbladder and stones are removed with the use of electric current or laser. An x-ray may be taken of the main bile ducts. The small incisions are closed with absorbable stitches. Usually patients will be walking and eating within hours.
Expectations and Complications of
Patients usually will go home within 24 hours and may resume regular diet and walking. Mild tenderness around the incisions is usually well managed by pain medication. A '“feeling of fullness” or nausea due to retained gas or anesthetic can occur during the first 24-48 hours. The patient may shower the next day.
Time Lost From Work
For most patients this more rapid return to work is another major cost reduction feature of laparoscopic cholecystectomy.
Classic Open Cholecystectomy
4 to 6 weeks
Laparoscopic Cholecystectomy
3 to 7 days
Summary
For many patients, laparoscopic cholecystectomy provides a shorter, less expensive, less painful solution to biliary tract disease and allows a more rapid resumption of leisure and work activities.
