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Approximately 500,000 gallbladder surgeries or cholecystectomies are performed each year in the United States. The most common reason for cholecystectomies is gallbladder pain (biliary colic) due to blockage of the cystic or bile duct by gallstones. Approximately 20 million adults in the U.S. have gallstones and an estimated one million people are newly diagnosed with gallstones each year.
The gallbladder is most commonly removed because of gallstones, but it may also be removed if the gallbladder is inflamed or infected. Gallbladder removal will relieve pain, treat infection and – in most cases – stop gallstones from coming back. The risks of not having surgery are the possibilities of worsening symptoms, infection and gangrene of the gallbladder.
Most gallbladder surgeries today are performed Laparoscopically, using small incisions through which a camera and operating instruments are inserted. The most common complications of gallbladder surgery are those which are associated with any surgery, namely wound infection and excessive bleeding. Complications specific to gallbladder removal include post-operative bile leak, injury to the main duct which transports bile from the liver to the intestine (called the common bile duct), and retained bile duct stones. There is also the possibility that the procedure cannot be completed laparoscopically and a larger incision would need to be made to take out the gallbladder.
Make sure your surgeon covers all aspects of the surgery with you prior to the procedure.
Some of the complications are as follows:
Pain, fatigue, nausea, vomiting and diarrhea especially after eating a fatty meal. This is due to the fact that instead of the bile being released in small amounts by the gallbladder, the liver releases the contents at once.
Injury to the bile duct is the most serious complication of laparoscopy, which could lead to leakage, tears, and the development of strictures that can lead to liver damage. Patients are always advised to avoid heavy lifting for at least 2 weeks.
In about 6% of procedures, the surgeon misses some gallstones, or they spill and remain in the abdominal cavity. In a small percentage of these cases, the stones cause obstruction, abscesses, or fistulas that may require open surgery.
Fortunately, complications after gallbladder surgery are fairly uncommon. Bleeding requiring a blood transfusion or infection occurs in less than 1% of elective cholecystectomies. In 1-2% of patients, the operation cannot be completed laparoscopically, and a traditional open operation is performed.
The most serious complication, injury to the common bile duct or hepatic ducts which drain bile from the liver into the intestine, occurs in 1/500-1/800 patients. This complication usually requires another operation to repair it. Other complications such as leakage of bile from the gallbladder or stones remaining trapped in the common bile duct occur in a small percentage of patients, may require an endoscopic procedure called ERCP to treat the problem.