Cholecystectomy

Cholecystectomy

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The gallbladder is a storage organ for a liquid within the body known as bile. The bile is made in the liver. It passes through bile ducts down to the small intestine where there is a valve. If the valve is open, the bile spills into the intestine to aid in digestion of fatty material. If the valve is closed, the bile backs up in the bile duct. If enough bile backs up in the main bile duct, it finds its way into the gallbladder which acts as a storage tank. The gallbladder concentrates the bile and holds it for future use. When the intestine is stimulated and signals that there is fatty material present, the valve at the bottom of the main duct opens and the gallbladder is stimulated to squeeze out the stored bile.

The trouble happens when the gallbladder develops problems. Gallstones can form in the stored bile. They can cause irritation of the gallbladder wall or obstruct its drainage duct causing pain and inflammation. Patients experience this pain in waves, usually beneath their rib edge on the right side. Ultrasound is done for evaluation and will usually demonstrate the problem.

The treatment for symptomatic gallbladder disease is removal of the gallbladder. There is no consequence to removal of the “storage tank.” The bile is still produced and delivered as above; it is simply stored in the main bile ducts instead of the gallbladder.

Removal of the gallbladder is called Cholecystectomy. It was done through open surgery with large incisions cutting through muscle and the full thickness of the abdominal wall until 1990. Surgeons developed the ability to remove it through four small puncture wounds laparoscopically. Open surgery had people hospitalized for a week, the laparoscopic approach, overnight or not at all. Laparoscopic cholecystectomy is currently done as an outpatient procedure. It is the most common laparoscopic procedure done each year across the country.

The NJ Bariatric Institute surgeons are experts in laparoscopy of all types. They perform laparoscopic cholecystectomy as an outpatient procedure and often use intraoperative X-ray testing to ensure that the remaining bile ducts are clear and functioning. They operate on both obese and non-obese patients who have gallbladder related disease.

Many morbidly obese patients have known gallstones. If they are symptomatic, our surgeons will generally recommend removal of the gallbladder. If they are not symptomatic, our surgeons will perform their weight loss procedures and monitor the situation. They may never need their gallbladder to be removed. If our patients become symptomatic after their weight loss surgery, we will operate. Because of the minimal scarring associated with our surgical technique and the laparoscopic approach, our surgeons can usually remove the gallbladder just as if the patient had never had prior surgery.

Patients generally return to light activity within hours and return to work in a week.