Gallstone surgery

Gallstone surgery is performed to remove the gallstones from the gall bladder of a person. Gallstones are small stones made from cholesterol, bile pigment and calcium salts.

Some facts about Gallstone surgery:

• Gallstones are hard deposits and  may range from the size of a grain of sand to the size of a golf ball that form in the gallbladder.
• An infection or a blocked bile or pancreatic duct can occur because of gallstones which can cause severe and often sharp pain.
• Bile is the fluid that helps digest food is stored in gallbladder. Hard fragments start to form when your bile gets out of balance.
• Your doctor may decide to remove your gallstone if it start to hurt or cause other symptoms as it don't go away on their own.
• Gallstones that do not cause problems are known as silent gallstones and does not require any treatment.
• People with asymptomatic gallstones should not undergo surgery due to the risk involved and the lack of benefit.
• Cholesterol and pigment are two type of gallstones. Cholesterol stones can be treated without surgical intervention where as surgical removal is required or pigment stones.
• Pigment stones are stones that are brown or black and are formed because of excess amount of bilirubin in the blood of a person.
• Shock wave lithotripsy, Endoscopic retrograde cholangiopancreatography and Oral dissolution therapy are some of the nonsurgical procedures for the treatment of gallstones.
• A surgery is recommended when attempts to dissolve or break up the gallstones do not work effectively.
• Cholecystectomyas will be performed as a precaution, even if you don't have symptoms if you have sickle cell or another blood disorder.
• Gallstones can also lead to more serious problems, like Cholecystitis, Pancreatitis or Cholangitis if left untreated
• Medication can be prescribed by your doctor to dissolve your gallstones which may take months or even years to work.
• Also there is a chance the gallstone may return even if they do go away.
• Preparation for Gallstone surgery:
• Your symptoms can be managed for a short time by making changes to your diet.
• A full physical examination will be done before undergoing surgery to determine if the person is healthy enough for the procedure.
• The surgeon can discuss the procedure, including what to expect and answer any questions after the examination.
• You will be asked to stop eating or drinking before few hours o surgery and take a shower the night before the procedure.
• Certain medications such as supplements, blood thinners, and medications that affect the immune system should be stopped before the surgery.
• Any approved medications can be taken in the morning of the surgery with a small amount of water.
• Blood test, Ultrasound, MRI HIDA scan and Endoscopic ultrasonography will be performed before your doctor opts for surgery to see the effect of gallstones on your health.  
• You need to discuss your medical historywith your doctor or surgeon before the operation, since some pre-existing conditions may influence decisions on surgery and anaesthetic.
• Any medications you take on a regular basis, including over-the-counter preparations should be informed to your doctor

Types of Gallstone surgery and its Procedure:

A surgeon can safely remove the gallbladder with a surgical procedure called cholecystectomy as the gallbladder is not an essential organ to human life.
Laparoscopic/robotic and open surgery are two types of surgery for gallstones.
A laparoscopic procedure is more likely performed than an open procedure by the surgeons.

Laparoscopic Cholecystectomy:

• General anesthetics will be used to put the person to sleep.
• Three or four incisions will be made and devices, called ports will be placed into the incisions to allow better access to the gallbladder.
• A small camera will be used by the surgeon to help them remove the gallbladder, before sealing the openings with stitches or staples.
• The ducts and artery that service the gallbladder are clipped shut which are permanent.
• The gallbladder, along with gallstones, will be pulled out of the body through one of the abdominal incisions.
• The incisions will be closed up and covered with dressings after the instruments and the carbon dioxide gas are removed from the abdominal cavity.
• Robotics can also be used sometimes to help with the surgery.
• These procedures are similar to other laparoscopic cholecystectomies, apart from the manipulation of the robot to perform the procedure.
• Gallstones that are blocking one or more bile ducts will be removed during the procedure. X-ray may also be used to help them see any additional stones and check for gallstones wedged in the bile ducts.

Open Cholecystectomy:

• An open cholecystectomy will be performed if the laparoscopic procedure does not go well.
• An open cholecystectomy can be done if the gallbladder is severely inflamed, badly infected or scarred from several other procedures.
• It is also performed for overweight or obesity, bleeding issues and poor visibility inside the body.

Recovery from Gallstone surgery:

• The recovery time of a person depends on the type of surgery they had and any complications that arose.
• A person can often go home the same day or the next day after laparoscopic cholecystectomy and expect to return to normal activities within one week.
• A person may need to stay in the hospital for up to a week after open cholecystectomy and can return to normal activities within one month.
• Developing an infection in the bile ducts of a person may be a complications from gallbladder surgery which may require additional surgeries.
• The person will need to keep the incisions clean and dry, change the bandages regularly, and follow all advice from their doctor for optimal healing.
• Any pain associated with the surgery can be managed by taking over-the-counter pain medications.
• Some short-term dietary changes, such as eating small, light meals for several days following surgery and following a low fat diet for a few weeks will be recommended by the doctor.
• Walking or doing some light exercises is recommended to help keep the body moving post surgery.
• A follow up appointment for about 2 to 3 weeks after the procedure will also be scheduled.