Gallstone surgery: definition, process, recovery, etc.

If the gallstones are severe, surgery must be performed. What is gallstone surgery like and what are the possible side effects?

What is gallstone surgery?

Gallstone surgery or also known as oesystectomy is a surgical procedure to remove the entire problematic gallbladder along with the stones in it.

The gallbladder is a small organ located in the upper right abdomen, to be precise, under the liver. Normally, the gallbladder is responsible for storing bile that has been produced by the liver.

However, don't worry if your gallbladder is removed. Your body can still function properly even without a gallbladder. Bile will continue to be produced by the liver and can function properly.

Furthermore, bile can be directly used by the body to digest food and break down fat without having to be stored first as usual.

What conditions do gallstone surgery require?

Generally, cases are mild and do not cause bothersome gallstone symptoms, surgery is not required.

Gallstone treatment will focus on prescribing gallstone crushing drugs such as ursodiol or chenodiol which must be taken regularly. These drugs are the first-line treatment commonly used before doctors recommend surgery.

Alternatively, the doctor will suggest a laser procedure shock wave orExtrotorporeal shock-wave lithotripsy (ESWL) to break stones without surgery.

Both procedures are performed by firing shock waves through the soft tissues of the body until the gallstone finally breaks.

New patients will be required to undergo surgery if the stones are large, fill the space in the gallbladder, or have entered to block one of the bile ducts.

In addition, gallstone removal surgery can also be performed if it causes more serious problems, such as pancreatitis (inflammation of the pancreas) or cholangitis (inflammation of the bile ducts).

When the gallbladder is no longer functioning properly and causing pain, the doctor may recommend gallstone surgery to avoid the risk of side effects or complications of inflammation of the gallbladder (cholecystitis).

Examination before gallstone surgery

Before undergoing surgery, the patient must undergo several tests to find out how much impact the gallstones have on the patient's condition. The tests include:

• blood test,
• Abdominal ultrasound,
• HIDA MRI test (hepatobiliary iminodiacetic acid) scan, a test to take pictures of blocked ducts using radioactive chemicals that are introduced into the body, as well as
• Endoscopic ultrasound, by inserting an endoscopic tube along the digestive tract to create detailed images of the bile duct.

The doctor will also ask about your history related to drug allergies, whether there are any neurological problems or disorders that you have experienced, whether you smoke actively or not, and many other things.

These questions will make it easier for your doctor to decide what anesthetic drug is safe for you, or whether you need an anesthetic test before surgery or not.

It is important to tell your doctor if you are still actively smoking. You are usually required to stop smoking 1-2 weeks before gallstone surgery to reduce the risk of respiratory problems and wound complications after surgery.

Also tell your doctor if you are using or taking certain non-prescription drugs, prescription drugs, herbal medicines, dietary supplements, herbs, or vitamins.

Some drugs can cause adverse reactions during surgery, including blocking the action of anesthetics. Your doctor may ask you to stop taking certain medications and supplements because they can increase your risk of bleeding during surgery.

Preparation of the patient before undergoing cholecystectomy

Closer to the surgery schedule, you will be advised to stay for 1-2 days in the hospital. During the hospitalization, the doctor will advise you to clean your stomach contents by drinking a special solution and fasting food 8-12 hours before surgery.

Even so, the patient may still be able to drink one to two sips of water to take medication before surgery. In addition, here are other preparations you need to consider.

1. Bring personal items

If you are advised to be hospitalized after and before gallstone surgery, don't forget to bring your personal belongings. Bring a copy or change of clothes, toiletries, sandals, and a book or magazine to fill the time during the hospitalization.

2. Invite people who can assist you

During the hospitalization until it is time to undergo surgery, ask someone to accompany you before and after the operation.

You can ask a spouse, parent, relative, or relative who is healthy and able to help you during your treatment.

also consider being discharged from the hospital with a companion. Going home after operations by driving a vehicle or taking public transportation by yourself is not recommended.

How is gallstone surgery done?

Entering the operating room, you will first be given anesthesia through intravenous (IV) fluids or an IV. In some cases, an anesthetic in the spine that is given by injection may be required.

After the anesthetic gets into the bloodstream, you will fall asleep for a long time. While waiting to fall asleep, you will be put on a mask and oxygen tube to make it easier to breathe.

You will not feel anything during the operation because you will be completely unconscious so you will not feel any pain at all.

Based on your condition, your doctor will perform one of two types of surgery methods.

1.Open cholecystectomy (open cholecystectomy)

Open cholecystectomy surgery (open cholecystectomy)

Also called open cholecystectomy, open cholecystectomy is a surgical procedure performed by making a large incision (about 13 - 18 centimeters) in the abdomen.

The surgeon will cut the layers of skin through the fat and muscle to make it easier to remove the gallbladder.

Then, the doctor will cut the gallbladder from the duct, remove the gallbladder, and clamp all the ducts that are connected to the bile.

While this process is taking place, a small tube will be inserted in and out of the stomach to drain the drained fluid.

The fluids are then collected in a small plastic bag that is connected to the hose. These tubes will be removed and removed from your body a few days later, before returning home.

Your doctor will recommend gallstone surgery if you have severe gallbladder problems, bleeding disorders, are overweight, or are in late pregnancy (second to third trimester).

People who have had scar tissue or other complications from previous operations on the abdominal area may also be advised of this surgery.

The recovery time after open cholecystectomy tends to be quite long. This is because open cholecystectomy involves a fairly large incision. So, his recovery time went a long way until he finally fully recovered.

Usually you will be asked to stay in the hospital 3-5 days after the operation. After being allowed to go home, you are still advised to rest for about 6 - 8 weeks until you can return to your activities.

2. Surgical cholecystectomy with laparoscopy (laparoscopic cholescystectomy)

Laparoscopic cholecystectomy (laparoscopic cholecystectomy)

The laparoscopic method of cholecystectomy is a type of surgery that is minimal incision. Usually, laparoscopic cholecystectomy only takes 1 - 2 hours.

This gallstone surgery is performed by making four small incisions in the abdomen to insert a long instrument with a camera into the area of ​​the bile.

The camera will help the doctor see and direct the laparoscopic motion in the body. When it reaches the target area, the laparoscopy will release carbon dioxide gas so that the condition in the stomach is easily visible on the screen.

Laparoscopy will then cut the sides of the bile duct to remove the stones inside. After making sure it is clean, the duct connected to the gallbladder will be closed with a special clip or glue.

Compared to open cholecystectomy surgery, recovery after surgery using the laparoscopic method does not take much time. The reason is, the pain in laparoscopic cholecystectomy is generally much lighter than open surgery.

You can generally go straight home the same day. However, this should be avoided. Doctors will usually still recommend that you be hospitalized first to monitor your condition and prevent complications.

You need about 1-2 days to stay in the hospital after this gallstone surgery. After returning home, the doctor will usually advise you not to do strenuous activities for at least 2 weeks.

Possible side effects of gallstone surgery

Cholecystectomy surgery is actually a fairly safe and effective procedure for removing gallstones.

However, just like any other medical procedure, these two types of gallstone surgery have a risk of side effects for some people, including:

• blood clotting,
• bleeding,
• infection,
• bile leak,
• injury to nearby organs or tissues, such as the liver, bile duct, and small intestine,
• swelling,
• damage to the surrounding blood vessels,
• pneumonia, as well
  
• heart problems.

Even though the risk of side effects may sound scary, your doctor will definitely recommend gallstone surgery after considering the greater benefits for you.

Recovery tips after gallstone surgery

After surgery, you will usually be advised to rest as much as possible to restore your body condition. Doctors generally don't allow you to do strenuous activities or lift heavy objects after gallstone surgery.

Also keep your body healthy by making sure you eat healthy foods. Avoid foods that cause gallstones, such as fatty, fried foods, or ready-to-eat instant foods.

You also have to be careful when doing activities at home to avoid the surgical incision scar opening and bleeding. This risk is especially high after open gallstone surgery where the incision is quite large and long.

Generally, your wound will dry up and heal within 4 - 6 weeks after surgery. However, you still have to be careful when treating surgical scars at home.

If the treatment is wrong, it is feared that it will cause infection in the wound. Here are things you can do.

• Always wash your hands with water and antibacterial soap before touching wounds or changing bandages.
• Don't take a shower, especially in the bath, until the wound on your stomach is covered with plastic or waterproof tape. Ask your doctor about bathing when you have a sore on your stomach.
• Avoid wearing clothes that are too tight or the material is too rough. This can make the gallstone surgery wound scratched and it will take a long time to heal.
• First avoid activities that endanger the surgical wound such as lifting heavy objects or swimming.

If there is clear fluid coming out of the wound that dries up, that's normal. However, if the discharge is pus or blood, immediately consult a doctor.

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