Cholecystectomy is an operation to remove the gallbladder. There are several ways to remove the hepatic bladder: simple open abdominal access and laparoscopic. It should be noted that today the open method has lost its relevance. Surgeons are often trying to resort to laparoscopic removal, because this method is not only more cosmetic, but also does not carry such serious postoperative complications as open surgery.
Laparoscopic surgery to remove the gallbladder is performed under general anesthesia in the operating room. The patient undergoes preoperative preparation, after which anesthesia is given.
The surgeon makes three or four incisions in the area of the projection of the liver onto the stomach. The incisions do not exceed 2 cm - this is quite enough for the introduction of trocars. Further, the abdomen must be "inflated", for this a certain amount of gas is introduced through the tube. This procedure is done so that the doctor can better see the location of all organs relative to each other.
The operation to remove the gallbladder proceeds in several successive stages:
- applying clamps to the cystic duct and large hepatic blood vessels (thus the surgeon will not allow a large loss of blood);
- direct removal of the gallbladder;
- suturing of laporoscopic incisions.
Thus, the operation to remove the gallbladder takes place without cavity penetration into the abdominal cavity. Modern laparoscopic devices allow reproducing the picture of internal organs on the screen in a very high quality, therefore, cavity removal of the bladder is impractical.
However, in some situations, the surgeon cannot perform laparoscopic removal of the gallbladder. This happens when:
- blood diseases occurring with insolvent hemostasis syndrome;
- terminal and coma;
- decompensated diseases of the lungs, heart and kidneys.
If a patient with cholelithiasis is diagnosed with peritonitis, suppuration of the gallbladder, as well as in the presence of pregnancy or other processes that could adversely affect the course of laparoscopic surgery, the surgeon may prefer open access.
It should be noted that in the absence of contraindications, it is best to carry out laparoscopic removal of the gallbladder. Patient reviews after this kind of surgical intervention are much better than after conventional cholecystectomy.
After only a few days after laparoscopy, patients can lead a familiar lifestyle, only limiting their physical activity for some time.
What complications can arise after gallbladder removal?
- Bleeding.
- Peritonitis, sepsis, or purulent inflammation.
- Suture failure, the formation of hematomas, fistulas and abscesses in the area of postoperative wounds.
- The formation of stones in the bile ducts.
- The passage of bile through the surgical wound.
- Tendency to thrombosis.
- Exacerbation of chronic bowel disease (ulcer).
- Damage to the renal vessels and ducts.
- Allergy to drugs or anesthesia.
As a prevention of the formation of stones in the ducts and maintenance of the body, it is necessary to follow a special diet after cholecystectomy. Patients should completely abandon products that enhance the formation of bile or adversely affect the liver.
It is necessary to eat food in small portions after a few hours. The number of meals can reach 6-8, but this should not scare patients.
It is necessary to exclude from the diet fried, baked, smoked food, as well as barbecue and pickles.
It is best to constantly use a double boiler, include in the diet more sour-milk products and soups (but not on fatty broths).