There are a myriad of diseases that could affect the gallbladder as well as the biliary tree such
as gallbladder cancer, gallbladder stones, biliary strictures and stenosis, calcification within
the gallbladder and biliary structures as well as congenital abnormalities associated with the
gallbladder and the biliary tree such as biliary atresia.
Complications associated with gallstones include pain and maldigestion of the ingested
food especially fats.
Indications for cholecystectomy
- Those with the clinical signs and symptoms of gallstones (cholelithiasis).
- Gallbladder inflammation in the case of infections (cholecystitis) is an
indication for cholecystectomy.
- If one is to undergo bariatric surgery in the case of obesity, cholecystectomy
could also be done.
- Those suffering from congenital hemolytic anemia should also be strongly
considered for the surgery as they are at increased risk for the complications associated with gallstones.
How is the procedure done?
The major surgical operation is cholecystectomy which involves the removal of the
gallbladder itself. A History of gallstones should be confirmed using radiological investigations such as
the ultrasound and before surgery is indicated. In addition to this, since about 80% of
the people with gallstones are asymptomatic, surgery is only strongly indicated to
those who develop symptoms of the gallstones and or the associated complications.
How you prepare for the surgery
- The patient should take prophylactic antibiotics before the surgery.
- Blood profile of the patient is done- this includes a full hemogram, liver function tests, and renal function tests.
- The ultrasound scans or other radiological investigations that have already been carried out should be brought to the surgeon in charge of the operation before the operation for analysis.
- Consent is mandatory before any procedure. The patient should be made aware of the risks and the benefits of cholecystectomy and left to decide then sign after they’ve fully understood everything.
Recovery after surgery
Surgery is usually done outpatient, and patients can go home the same day of surgery. The average healing time is about 6-8 weeks, where the patients can comfortably go back to their normal routine and work.
You can resume your normal diet immediately but adhere to the instructions given by the
health practitioners regarding dieting. You should start with small frequent meals and
scale up gradually. It should be a balanced diet but avoid taking fatty foods as your body is
getting accustomed to the new way of digesting fat. Plenty of water intake should accompany
the healthy diet.
Outcomes after surgery
Post-cholecystectomy syndrome: Rarely, in about 15% of the patients, the clinical signs and
symptoms that were the key indications for the cholecystectomy don’t go away. It could be a
result of the presence of other unidentified stones in the biliary tree, surgical damage to the
biliary tree or just a continuation of the symptoms and should be investigated further.