Gallbladder and Biliary Surgery

Removing the gallbladder (cholecystectomy) is a common procedure in our community and is mostly performed for symptoms arising from the gallbladder due to gallstones. Occasionally the gallbladder is removed as it is no longer functioning properly (Gallbladder Dysfunction) or there is concern regarding a polyp or potential malignancy.

This is the removal of the gallbladder via keyhole surgery and is performed under a general anaesthetic. This procedure involves a small incision (around 10mm) around the navel (umbilicus) and three 5mm incisions under the right side of the rib cage. The gallbladder is dissected off the liver and surrounding structures and then removed in a small bag via the umbilical port. An X-Ray (cholangiogram) of the bile duct is also normally performed during the operation to ensure there are no abnormalities with or stones inside the bile duct. The bile duct is the main drainage tube from the liver. This procedure normally takes around 45 minutes and you are in hospital for one night following the operation. Very occasionally the procedure is unable to be safely performed with keyhole surgery and a larger incision needs to be made in the upper abdomen. Patients normally take around 1-2 weeks off prior to returning to work however many work from home during this time. Light exercise can normally commence in 1-2 weeks however it takes around 4 weeks to get back into strenuous exercise.

This procedure is performed via a larger incision in the upper abdomen, usually under the right side of the rib cage or in the midline. It may be necessary to perform an open operation if the keyhole technique is unable to be safely performed due to previous scarring or severe gallbladder inflammation. For some conditions eg. Suspected gallbladder cancer, an open procedure may be recommended by your surgeon. In general, an open procedure will take longer to recover from and has an increased risk of wound complications such as infection or post operative hernia.

Biliary surgery refers to surgery of the gallbladder and/or the bile duct. Surgery of the bile duct is normally performed for malignancy, stricture (narrowing) or gallstones that are unable to be removed via less invasive procedures. Often the bile duct needs to be re-joined to the bowel in order for the liver to drain properly. Your surgeon will discuss with you the exact type of biliary surgery they are proposing and the reasons for doing so.

All surgery carries risks and gallbladder surgery is no different. Although laparoscopic cholecystectomy is generally very safe some of the complications that may occur include a leakage of bile following the procedure (around 1:300 risk), damage to other organs such as the small bowel, wound infection or a hernia at the port sites. Other general operative risks include clots in the legs (Deep Vein Thrombosis/DVT) or lungs (Pulmonary Embolism/PE), chest infection or severe reaction to the anaesthetic agents. All care is taken to avoid these complications using certain medications and stockings however they may still occur.