About Gall Bladder Surgery

Gallbladder surgery is an operation called a cholecystectomy. More than 500,000 gallbladder surgeries are performed in the United States annually. Reasons for gallbladder surgery include presence of gallstones, gallbladder dysfunction, gallbladder infection and gallbladder tumors. Modern surgical techniques and procedures have made gallbladder a relatively safer operation than in years past.

History

• Early gallbladder surgery did not involve the removal of the gallbladder itself. These early operations consisted of entering the abdominal cavity, opening the gallbladder and removing the stones. The gallbladder was closed, and amazingly the patients did very well. The first such operation was performed in Indianapolis in 1867. In 1882 a surgeon by the name of Johann August Langenbuch proposed that the entire gallbladder be removed. After years of experimentation and development, the removal of the gallbladder has become the operation of choice for gallstones and gallbladder disease.

Function

• The gallbladder is a hollow organ located within the abdominal cavity attached to the underside of the liver. The primary function of the gallbladder is to store bile, an enzyme used in digestion, produced by the liver. The liver produces bile at a constant rate not determined on the need. The excess is stored in the gallbladder until needed. When the bile is needed, the gallbladder contracts and secretes bile through the cystic duct into the common duct where the bile passes into the digestive tract.

Types

• There are two types of gallbladder surgery performed today. They are the open cholecystectomy and the laparoscopic cholecystectomy.
  The vast majority of gallbladder surgeries performed today are the laparoscopic cholecystectomies. The surgeon and surgical team use a small telescope and specialized laparoscopic instruments to remove the gallbladder. This operation is performed through three or four small incisions measuring 5 to 10 mm in length. Special trocars or cannulas are inserted through these incisions into the abdominal cavity. The abdominal cavity is inflated with CO2 gas to create a space. The gallbladder is detached and removed through one of small incisions.
  The open cholecystectomy requires a large incision of the abdominal wall. The abdominal cavity is entered, and the gallbladder is removed by conventional surgical technique. The large incision is then closed.

Considerations

• There are many considerations the patient must weigh when facing gallbladder surgery. The first is which type is best for the condition that is present. They both have their positive and negative aspects. Patients must consider if there are any alternatives to gallbladder surgery. Patients must also consider the skill of the surgeon and ask questions of the surgeon. Some questions should include the number of surgeries the surgeon has performed, the success rate and the complication rate. Other considerations may include adequate support during the recovery period.

Benefits

• The benefits of gallbladder surgery outweigh the downfalls, especially with today's laparoscopic techniques. Patients with gallstones will have either persistent or occasional gallbladder attacks involving severe pain. Gallstones may lead to further complications including jaundice (turning yellow) and severe infection of the gallbladder. This condition may be detrimental to the health of the patient. Patients can die from complications from advanced gallbladder disease. Removal of the gallbladder will relieve the patient of symptoms and may cure any adverse health issues. Gallbladder surgery can save a patient's life.

Theories/Speculation

• The advancement of gallbladder surgery continues today. A new type of gallbladder operation is being developed and may soon be available to the public, called Natural Orifice Translumenal Endoscopic Surgery (NOTES). This new revolution requires no incisions on the abdomen. Laparscopic and endoscopic surgical techniques use natural orifices such as the vagina, rectum and mouth. Gallbladder surgery will soon be performed using this method.