Biliary Disease
Gallstones / Gallbladder inflammation (cholecystitis)
Bile, which is necessary for the digestion of fat, is produced in the liver. A portion of the bile is stored in the gall bladder under the liver and then released into the duodenum when the digestion process commences. Bile has several components (including cholesterol and bilirubin) which can form gallstones of various sizes within the gallbladder. Gallstones can lead to pain in the right upper abdomen or colic, and often results in inflammation of the gallbladder.
Small gallstones can slide from the gallbladder into the common bile duct, causing it to become blocked. Bile accumulates as a result, leading to jaundice (icterus).
Symptoms of gallstones include pain in the upper right abdomen, which may be cramp-like and radiate into the right shoulder. This often occurs after eating fatty foods. Lightly coloured faeces and dark urine can be an indication of a blocked common bile duct. Gallbladder inflammation (cholecystitis) may also be accompanied by fever.
As long as gallstones do not cause symptoms, they do not require treatment. However, if complaints and discomfort do occur, an operation is advisable as the pain often recurs.
Gallstones and inflammation of the gallbladder are detected by means of an ultrasound examination of the upper abdomen. In addition, blood samples are analysed. In cases where the presence of gallstones is suspected in the common bile duct, an endoscopy similar to a gastroscopy can be performed, a procedure during which the stones can also be removed (ERCP).
Gallbladder surgery
It is currently standard procedure to perform a cholecystectomy (gallbladder removal) using minimally invasive surgery (MIS).
This involves a small incision near the navel through which a camera is inserted into the abdominal cavity, and three small incisions in the upper abdomen to allow for insertion of laparoscopic instruments so that the gallbladder can be surgically removed.
In over 90% of patients, the gallbladder can be operated on using minimally invasive surgery. In 5-10% of patients, the switch to an open operation with a large abdominal incision under the right costal arch has to be made - for example, if there is severe inflammation of the gallbladder or extensive adhesions from previous operations.
On the whole, laparoscopic cholecystectomy is a very safe operation. Potential complications of the operation include injury to the bile ducts (0.3-0.5%), bile leakage / biliary fistula (0.5%), post-operative haemorrhage (<1%), injury to adjacent organs (0.1%) or impaired wound healing (1-5%).
Following the surgery
You may return to a normal diet the day after gallbladder surgery. A special diet is not necessary after the operation.
After 3-5 days you will be able to leave the hospital. On the tenth day after surgery, the stitches can be removed in an outpatient procedure.
Following minimally invasive surgery, we recommend a physical resting period of about 14 days until the wounds have completely healed. After an open operation, you should avoid strenuous activity for three months to avoid scar rupture.
