The gallbladder is located inside the right side of the abdomen, underneath the liver. It stores bile that is produced by the liver, and delivers it to the first part of the small intestine (duodenum), where it aids in the digestion of fat. The cystic ducts and common bile ducts connect the gallbladder to the duodenum, and allow bile to pass through.
Gallbladder surgery is performed to treat gallbladder disease, which mainly consists of the formation of gallstones in the gallbladder (cholelithiasis). Gallstones cause: obstruction of the cystic duct leading to severe abdominal pain (biliary colic) infection or inflammation of the gallbladder (cholecystitis) blockage of the biliary ducts leading to the duodenum (biliary obstruction) In each case, removal of the gallbladder (cholecystectomy) is necessary.
Most gallbladder surgery performed today entails laparoscopic surgical techniques, in which narrow instruments, including a camera, are introduced into the abdomen through small puncture holes. If the procedure is expected to be straightforward, laparoscopic cholecystectomy is used. A laparoscopic camera is inserted into the abdomen near the umbilicus (navel). Instruments are then inserted through two or more small puncture holes. The gallbladder is found, the vessels and tubes are cut, and the gallbladder is removed.
If the gallbladder is extremely inflamed, infected, or has large gallstones, the abdominal approach (open cholecystectomy) is recommended. A small incision is made just below the rib cage, on the right side of the abdomen. The liver is then moved to expose the gallbladder. The vessels and tubes (cystic duct and artery) connected to the gallbladder are cut, and the gallbladder is removed. The tube (common bile duct) that drains the digestive fluid (bile) from the liver to the small intestine is examined for blockages or stones. If there is inflammation or infection, a small, flat tube is left inside for several days to drain out fluids.
Most patients who undergo laparoscopic cholecystectomy go home the day of surgery. They immediately resume a normal diet and normal activities. Most patients who undergo open cholecystectomy require five to seven days of hospitalization. They resume a normal diet after one week, and normal activities after four to six weeks.
