Cholecystectomy - Medical Negligence Lawyers
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A cholecystectomy is a surgical procedure in which the gallbladder is removed. The gallbladder is a pear shaped abdominal organ that lies tucked beneath the liver in the upper right quadrant of the abdomen. The gallbladder's function is to collect and store bile, which is initially made in the liver and is used as a digestive aid.
A person might need a cholecystectomy if there is chronic pain from gallstones, which inhibit the flow of bile. A cholecystectomy is considered a common surgical procedure that usually has no serious complications. In general, a cholecystectomy is a same day procedure although some patients do stay overnight following surgery.
Historically speaking, cholecystectomy procedures were done in an open fashion with a several inch incision required. Now, most cholecystectomy procedures are done laparoscopy. It involves using a small incision to insert a camera to visualize the gallbladder. The area is inflated with carbon dioxide to better see the structures and other incisions are made to insert tools that cut off the gallbladder and remove it through an opening.
The major reason that a cholecystectomy is done is to remove gallstones and get rid of their complications. Other reasons why a cholecystectomy might be done are the following:
- Inflammation of the pancreas (pancreatitis).
- Stones within the gallbladder (also called cholelithiasis).
- Stones in the bile duct (also called choledocholithiasis).
- Inflammation of the gallbladder (also called cholecystitis).
Cholecystitis is generally considered to be a safe procedure but it does carry risks and complications you should know about:
There can be bile leakage into the abdominal cavity.
Bleeding that cannot be controlled.
Blood clots in the deep veins of the legs.
Death from pulmonary embolism or other reason.
Infection from the wound.
Injury to the liver, bile duct, and small intestines.
The risk of complications is greater if you're older or if you have health problems. The risk of surgery is worse if your gallbladder is in bad shape.
The surgery is performed under general anaesthesia so you do not know that the surgery is taking place. The anaesthesia drugs are given by IV means. A tube is inserted into your throat after the anaesthesia kicks in so you can breathe. The doctor does the cholecystectomy while you are under general anaesthesia.
The different types of cholecystectomy include:
- Minimally invasive or laparoscopic cholecystectomy. There are four incisions placed in the area of the gallbladder. A tiny video camera is inserted in one small incision. Carbon dioxide is used in another incision in order to inflate the area. Tools are used in other incisions in order to cut and lift the gallbladder out of the body. Ultrasounds are done to make sure the gallstones aren't present in the bile ducts. If they are, the stones are removed.
- In a traditional cholecystectomy, a six inch incision Is made in the right upper quadrant. The liver and gallbladder are directly visualized and the surgeon removes the gallbladder easily. The length of time to undergo an open cholecystectomy is about two hours.
Following the cholecystectomy, the patient goes to the postoperative recovery area. In a laparoscopic cholecystectomy, the patient usually rests for a while and goes home the same day as the surgery. In some cases, they stay overnight the next day in the hospital. If they can eat and drink and have no pain, and if they can walk, they can be discharged. They will recover at home in about one week.
If the patient has an open cholecystectomy, they will stay in the hospital for 2 to 3 days for recovery. After they return home, it takes about four to six weeks for recovery.
Cholecystitis can be divided into chronic cholecystitis and acute cholecystitis. In either chase there is an inflammation of the gallbladder or infection of the gallbladder that causes abdominal pain and other symptoms.
The causes of acute cholecystitis in ninety percent of cases are gallstones in the gallbladder that back up bile and cause inflammation and infection of the lining of the gallbladder. You can also get acute cholecystitis with tumors of the gallbladder and with severe illness. Bile becomes trapped in the gallbladder and causes an increase in the pressure of the gallbladder and inflammation or irritation of the gallbladder. This can secondarily lead to bacterial infection and ultimate perforation of the gallbladder.
Gall stones increase with age and are more common in women. Native Americans get more gallstones than others and therefore get more cholecystitis.
The main symptom of acute cholecystitis is abdominal pain in the right upper quadrant abdominal pain. The pain can be dull or sharp and cramping; it may come and go and it may have spread to the back or to the right shoulder blade. It can occur within minutes of having a meal. Related symptoms include abdominal fullness, clay coloured stools, fever, nausea and vomiting and yellowing of the whites of the eyes and the skin. This is called jaundice and is a sign that the cholecystitis has been going on for a while.
Doctors can do a physical examination of the abdomen and can find tenderness to the touch of the right upper quadrant. Blood tests for lipase and amylase are done to see if the pancreas is inflamed and a bilirubin test can tell if the liver is involved. Other liver function tests can be done as well. A CBC can show a high white blood cell count. To image the gallbladder, an abdominal ultrasound, CT scan of the abdomen, abdominal x-ray and oral cholecystogram can be done. There is a specialized test called a gallbladder radionuclide scan that can use radioactive particles to outline the gallbladder on a film.
Treatment of acute cholecystitis involves seeking immediate medical attention if the pain is prolonged or severe. Fluids are given by IV along with antibiotics to fight off infection. Surgery to remove the gallbladder is the preferred treatment, unless the cholecystitis gets better on its own. Surgery can be delayed if antibiotics settle the inflammation down. Pain medications can be given and a low fat diet is recommended until the gallbladder can be removed. You may need emergency cholecystitis surgery if there is gangrene of the gallbladder, pancreatitis or perforation of the gall bladder. If the bile ducts become inflamed, too, you need to have emergency surgery. Sometimes, a tube might be placed through the skin so that the gallbladder is drained before surgery can be safely performed.
The prognosis of cholecystitis is excellent as long as the gallbladder is removed. Most people have their gallbladder removed via a laparoscope so that the incisions are small and heal very fast.
Chronic cholecystitis involves a longer period of irritation and swelling of the gallbladder. It usually occurs after repeated bouts with acute cholecystitis. This thickens the walls of the gallbladder and the gallbladder begins to shrink. It eventually fails to work and cannot store bile. Women get this disease more commonly than men and it is of a greater incidence in women over the age of forty. Risk factors for the disease include having gallstones and having them block the exit to the gallbladder.
Symptoms include having attacks of right upper quadrant abdominal pain associated with nausea or vomiting.
Tests for chronic cholecystitis are the same as for acute cholecystitis and include an abdominal ultrasound, a CT scan of the abdomen, a HIDA scan or radioactive scan of the gallbladder and an oral cholecystogram.
The treatment of chronic cholecystitis involves doing surgery to remove the gallbladder. This is called a cholecystectomy. Laparoscopic surgery is what is usually performed but open abdominal surgery is also possible.
Complications of chronic cholecystitis include a rare case of gallbladder cancer, jaundice, pancreatitis or worsened cholecystitis.
Cholecystectomy Medical Negligence Solicitors
Our personal injury solicitors operate a specialist medical negligence compensation service. Our Cholecystitis solicitors deal with claims using a no win no fee arrangement which means that if you don't win then you don't pay them their professional costs. If you would like legal advice at no cost with no further obligation just complete the contact form or email our lawyers offices or use the helpline and a Cholecystitis medical negligence solicitor will review your medical negligence compensation claim and phone you immediately.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here