HOW TO PREPARE FOR THE GALLBLADDER SURGERY OR CHOLECYSTECTOMY?
What Is The Gallbladder?
The gallbladder is an organ present in the human body. The shape and size of the gallbladder are just like a small pear. Gallbladder stores bile made by the liver. It keeps the bile until the body needs it to digest fatty foods.
What Causes The Pain In The Gallbladder?
Gallstones are the cause of the pain. These small, hard deposits form in the gallbladder that disrupts the function of the digestive system. They can also get into the bile duct, which connects the gallbladder with the intestines.
One can get gallstones if:
- Woman generally suffers because of gallstones more than men
- Post pregnancy can cause gallstones
- An overweight person is more often to suffer from gallstones
- Not drinking enough water can cause gallstones in some cases
What are the possible symptoms of gallbladder problems?
The possible symptoms include:
- Sharp pain in the abdomen
- Nausea and vomiting
- Indigestion and Fever
How do doctors detect gallbladder problems?
The doctor generally prefers a test called an ultrasound A doctor might also suggest CT scans or a test called a HIDA scan. The HIDA scan is done through an injection of dye to show how well the gallbladder and bile duct are functioning.
What is Cholecystectomy?
A Cholecystectomy is the removal of the gall bladder. Our gallbladder collects and stores bile which is a digestive fluid produced by the liver. Cholecystectomy is a surgical process to operate and remove the gall bladder that is a pear-shaped organ below the liver on the upper right side of the human abdomen. A cholecystectomy is a common surgery and it has no risk.
Who needs to have a cholecystectomy?
The individual who has gallstones should go for a laparoscopic cholecystectomy. Gallstones are crystals that form in the gallbladder. They block the flow of bile out of the gallbladder into the digestive system. This blockage causes cholecystitis that is inflammation of the gallbladder. Gallstones sometimes move to other parts of the body which causes problems. The symptoms of gallstones in the body include:
- Feeling bloated
- Pain in the right side of the abdomen
Why is a cholecystectomy done?
A cholecystectomy is performed to treat gallstones. Doctors might recommend a cholecystectomy if someone has:
- Cholelithiasis or Gallstones in the gallbladder
- Choledocholithiasis or Gallstones in the bile duct
- Cholecystitis or Gallbladder inflammation
- Large gallbladder polyps
- Pancreatitis or Pancreas inflammation due to gallstones
How is Cholecystectomy performed?
A cholecystectomy is most commonly performed by inserting a tiny video camera and special surgical tools through four small incisions to see inside the abdomen and remove the gallbladder. Doctors also call this a laparoscopic cholecystectomy. In a few cases, a large incision may be used to remove the gallbladder. This is called an open cholecystectomy.
How to prepare for cholecystectomy?
The preparation for cholecystectomy is simple and easy. One should adhere to a few rules to avoid any sort of risk.
- Food and Medications: one should not eat anything the night before cholecystectomy. One can sip water in regular intervals or with the medications, but one must avoid eating and drinking at least four hours before the surgery is performed.
One should also stop taking certain medications and supplements. They should listen to the doctor and inform him about all the medications and supplements. Only prescribed medicines should be taken into consideration. Doctors might ask to stop taking certain medications and supplements because they might increase the risk of bleeding.
- Clothing: cholecystectomy is simple and not much risky so most people get discharged right after the surgery. However, some complications might occur after the surgery. One should be prepared and stay in the hospital with enough clothing and personal items.
- Asking for a helping hand: One should find someone who can drive the patient home or stay with the patient.
What to expect after a cholecystectomy?
Before the surgery
A cholecystectomy is a simple surgery thus performed using general anesthesia. Anesthesia helps the patient to ease the pain. Drugs are given through a vein in the arm of the patient. The drug helps the patient to be unconscious. The surgeon then inserts a tube down the throat to help the patient breathe. Then he performs the cholecystectomy using either a laparoscopic or by open procedure.
During the surgery
Surgeons generally recommends two surgical procedures:
- Laparoscopic cholecystectomy or minimally invasive surgery:
During a laparoscopic cholecystectomy, the surgeon makes four small incisions in the abdomen. A tube with a tiny video camera is inserted inside the abdomen through one of the incisions. The surgeon then watches a video monitor in the operating room while using surgical tools inserted through the other incisions in the abdomen to remove the gallbladder.
After this procedure, the patient might undergo an imaging test, such as an X-ray or ultrasound, if the surgeon is concerned about possible gallstones or other problems in the patient’s bile duct. The incisions are then sutured, and the patient is taken to a recovery area. A laparoscopic cholecystectomy takes hardly one or two hours.
A laparoscopic cholecystectomy isn't appropriate for everyone. In some cases, the surgeon might begin with a laparoscopic approach and find it necessary to make a larger incision because of scar tissue from previous operations or complications.
- Open Cholecystectomy or Traditional Surgery:
Open cholecystectomy is performed when the surgeon makes a 6-inch or 15-centimeter incision in the abdomen below the patient’s ribs on the right side. The muscle and tissue are pulled back to reveal one’s liver and gallbladder. In this way, the surgeon removes the gallbladder. The incision is sutured, and the patient is taken to a recovery area. An open cholecystectomy hardly takes one or two hours.
After the Surgery
Post cholecystectomy the patient is taken to the recovery area as the anesthesia drugs wear off. Then he or she is taken to a hospital room to continue recovery. The complete recovery of the patient varies depending on the procedure:
Laparoscopic cholecystectomy: This process is the simplest one. The patient generally goes home the same day as their surgery. Surgeons might prescribe a one-night stay in the hospital if needed. One can expect a quick discharge from the hospital in this procedure. The patient is also able to eat and drink without pain and are able to walk unaided. It takes nearly about a week to fully recover.
Open cholecystectomy: This procedure is a bit complicated one. One can expect to spend two or three days in the hospital recovering. Once at home, it might take up to four to six weeks to fully recover.
What are the results to be expected after cholecystectomy?
A cholecystectomy can relieve the pain and discomfort of gallstones. Conservative treatments usually can't stop gallstones from recurring. In most cases, a cholecystectomy prevents gallstones from coming back. Most people don’t experience digestive problems after a cholecystectomy. The gallbladder isn't essential to healthy digestion. Some people might experience occasional loose motion after the procedure. This generally resolves over time. One should discuss with the doctor regarding any changes in the bowel habits or new symptoms following the surgery. One should take adequate rest post-surgery. The complete recovery would take some time depending on the type of surgery used on overall health. People undergoing a laparoscopic cholecystectomy may be able to go back to work in a matter of days. Again, people undergoing an open cholecystectomy may need a week or more to recover enough to return to work.
What can be the possible risks post cholecystectomy?
A cholecystectomy has less complications and minimal risk: They can be:
- Bile leak
- Scars or a numb feeling at the incision site
- Liver injury
- Injury to the tube that carries bile from the gallbladder to the small intestine
- A bulging of organ or tissue at the incision site
- Injury in nearby structures, such as the bile duct, liver and small intestine
- Risks of general anesthesia, such as blood clots or pneumonia
- Pain due to surgical tools that are put into the belly
These might be some risks but the complications depend on the overall health and the reason for the cholecystectomy. The patient might have other risks too. One should take adequate precautions and medications post-surgery. He or she should inform the doctor if he or she faces any further complications.
What to eat after a cholecystectomy?
- After having cholecystectomy or removal of the gall bladder, patients might develop frequent loose motion and watery stools. In most cases, the diarrhoea lasts for a few weeks to a few months. There isn't any specific gallbladder removal diet that a patient should follow but one should keep a track of what he is consuming.
- Diarrhoea after gallbladder removal seems to be related to the release of bile directly into the intestines. In a human body, the gallbladder collects and concentrates bile, releasing it when someone eats to aid the digestion of fat. When the gallbladder is removed, bile is less concentrated and drains more continuously into the intestines, where it can have a laxative effect. So, one should avoid consuming fats. The amount of fat a patient eats at a time also plays a role. Smaller amounts of fat are easier to digest, while larger amounts can remain undigested and cause gas, bloating and more diarrhoea.
- One should avoid fats. Having high fat foods, fried and greasy foods, and fatty sauces and gravies after the surgery can create irritation in the stomach. One can choose for low fat foods and those which are no more than 3 grams of fat a serving.
- One can increase the fiber in the diet. This helps in normalizing the bowel movement. One should add soluble fibre, such as oats or barley, to one’s diet. One should increase the amount of fiber slowly, because too much fiber at first can make gas and cramping worse.
- One should eat smaller but frequent meals. A healthy meal should include protein, such as poultry, fish or fat-free dairy, vegetables, fruits and whole grains.
- One should avoid consuming coffee, Dairy products, very sweet foods to worsen the cramps.
- One should consult a doctor if the diarrhoea doesn't go away or becomes more severe. A proper check-up with follow up is mandatory for the patient. Doctors may recommend medicines, such as loperamide (Imodium A-D), which slows down intestinal movement, or medications that decrease the laxative effect of bile, such as cholestyramine. Multivitamins are also suggested to compensate malabsorption of fat-soluble vitamins.
What can the patient do at home?
The patient should take a rest and try walking slowly to prevent blood clots. One should avoid lifting anything for about 2 to 4 weeks, which would make him/ her strain in the belly area. Strenuous activities must be avoided such as biking, jogging, weightlifting, and aerobic exercise, until the doctor permits. However, one should go for light exercises, without pressurising the belly area. One should follow a nutritious diet and maintain a healthy lifestyle post-operation. One should take proper medicines as prescribed to heal fast. One should always seek help from the family members and tell them the issue if any complication arises. One should drink plenty of water and stay hydrated. One should always take care of the wounds following the instructions of health care professionals.
How is gallbladder removal beneficial?
Gallstones can create pain in the abdomen that spread up to the shoulders. Removing the gallbladder will stop the pain and treat the infection caused by gallstones. It can also stop gallstones from coming back. However, if gallstones are not treated, pain and infection can get worse. The gallbladder may burst which is dangerous.
If a patient is suffering from severe pain in the abdomen, he or she should immediately get it diagnosed. Doctors or surgeons would then determine whether to go for open or laparoscopic cholecystectomy. The laparoscopic procedure is beneficial as it causes less pain and lowers the risk of complications. The patient gets quicker recovery and return to regular activities fast. The laparoscopic procedure creates smaller wounds and scars too.