Main bile duct injury The greatest risk during cholecystectomy is injury to the main bile duct. Once in every three hundred operations is the typical frequency of this problem. As it requires major surgery to fix this problem all surgeons are acutely aware of it and make every attempt to avoid it.
Other abdominal problems The other post operative difficulties which can occur inside the abdomen, such as bile leakage, do not usually present themselves until after patients have been discharged. The development of increasing pain in the abdomen or the occurrence of jaundice with its typical yellowy skin colour mean the patient should consult a doctor immediately.
Diarrhoea A small percentage of patients notice their bowels become looser after cholecystectomy. This is usually very minor but occasionally medication is needed to control this effect.
Clotting problems in the legs (DVT) Having a cholecystectomy incurs a small risk of getting a deep vein thrombosis and so they are uncommon overall. A history of previous thromboses or being on the contraceptive pill is increased risk factors and surgeons will ensure that these risks are reduced by special measures. Other measures which help are keeping the lower limbs moving as soon after the procedure as possible and encouraging early mobility.
The risks of a general anaesthetic General anaesthetics have some risks which may be increased in the presence of chronic medical conditions but are in general:
Common but short term effects (risk of 1 in 10 to 1 in 100) are a feeling of sickness and blurring of vision (which can be treated and usually resolve quickly) and injection site discomfort and bruising.
Less common side effects of 1 in a hundred to 1 in 10,000 risk can be breathing and speaking problems which are short term, headache, pains in the muscles, sore throats and teeth, tongue and lip damage.
Very rare and very serious side effects (less than one in ten thousand risk) are long-term damage to nerves or blood vessels, liver and kidney failure, damage to the brain, voice box or lungs, eye injury, severe allergy reactions and death. These occur very rarely and may be related to the other medical conditions the patient is suffering from.
What is the benefit of laparoscopic cholecystectomy? Surgeons have changed from traditional open cholecystectomy to laparoscopic cholecystectomy because it has several benefits. The main ones are minimal scarring, less pain after the operation, a reduced risk of infection and a faster recovery time. Most patients are now able to be up and about and home within 24 hours of the operation and should be able to return to work within 7 days. Laparoscopic surgery is no longer new and the consultant will have performed many of these operations.
Action in the case of a problem Consultation with the family doctor is the best first step if an acute problem presents itself such as a high temperature or a wound discharge. The doctor may refer the patient to the hospital surgeons and if so will make the arrangements. In the event of a patient being unable to access urgent medical review from a local general practitioner they should present themselves to the Emergency Department of the nearest major hospital.
PCS or Postcholecystectomy Syndrome
Post cholecystectomy syndrome (PCS) is a blanket term for a collection of symptoms presenting after the removal of the gall bladder. This can include problems which were diagnosed as gallbladder problems continuing on after removal, the emergence of new symptoms which seem attributable to gall bladder problems and new difficulties related to removal of the organ itself. The reservoir for bile has been taken away, changing the flow of bile to the digestive tract, with increased amounts causing abdominal sharp pains and loose stools in the lower tract and stomach and oesophagus inflammation in the upper.
About 10-15% of cholecystectomy patients may complain of such symptoms and careful discussion of potential post-operative complications is necessary for PCS problems to be identified. The most secure way of reducing the risk of PCS developing is to get a clear diagnosis that the gallbladder is the organ causing the patients symptoms. - 20761
Other abdominal problems The other post operative difficulties which can occur inside the abdomen, such as bile leakage, do not usually present themselves until after patients have been discharged. The development of increasing pain in the abdomen or the occurrence of jaundice with its typical yellowy skin colour mean the patient should consult a doctor immediately.
Diarrhoea A small percentage of patients notice their bowels become looser after cholecystectomy. This is usually very minor but occasionally medication is needed to control this effect.
Clotting problems in the legs (DVT) Having a cholecystectomy incurs a small risk of getting a deep vein thrombosis and so they are uncommon overall. A history of previous thromboses or being on the contraceptive pill is increased risk factors and surgeons will ensure that these risks are reduced by special measures. Other measures which help are keeping the lower limbs moving as soon after the procedure as possible and encouraging early mobility.
The risks of a general anaesthetic General anaesthetics have some risks which may be increased in the presence of chronic medical conditions but are in general:
Common but short term effects (risk of 1 in 10 to 1 in 100) are a feeling of sickness and blurring of vision (which can be treated and usually resolve quickly) and injection site discomfort and bruising.
Less common side effects of 1 in a hundred to 1 in 10,000 risk can be breathing and speaking problems which are short term, headache, pains in the muscles, sore throats and teeth, tongue and lip damage.
Very rare and very serious side effects (less than one in ten thousand risk) are long-term damage to nerves or blood vessels, liver and kidney failure, damage to the brain, voice box or lungs, eye injury, severe allergy reactions and death. These occur very rarely and may be related to the other medical conditions the patient is suffering from.
What is the benefit of laparoscopic cholecystectomy? Surgeons have changed from traditional open cholecystectomy to laparoscopic cholecystectomy because it has several benefits. The main ones are minimal scarring, less pain after the operation, a reduced risk of infection and a faster recovery time. Most patients are now able to be up and about and home within 24 hours of the operation and should be able to return to work within 7 days. Laparoscopic surgery is no longer new and the consultant will have performed many of these operations.
Action in the case of a problem Consultation with the family doctor is the best first step if an acute problem presents itself such as a high temperature or a wound discharge. The doctor may refer the patient to the hospital surgeons and if so will make the arrangements. In the event of a patient being unable to access urgent medical review from a local general practitioner they should present themselves to the Emergency Department of the nearest major hospital.
PCS or Postcholecystectomy Syndrome
Post cholecystectomy syndrome (PCS) is a blanket term for a collection of symptoms presenting after the removal of the gall bladder. This can include problems which were diagnosed as gallbladder problems continuing on after removal, the emergence of new symptoms which seem attributable to gall bladder problems and new difficulties related to removal of the organ itself. The reservoir for bile has been taken away, changing the flow of bile to the digestive tract, with increased amounts causing abdominal sharp pains and loose stools in the lower tract and stomach and oesophagus inflammation in the upper.
About 10-15% of cholecystectomy patients may complain of such symptoms and careful discussion of potential post-operative complications is necessary for PCS problems to be identified. The most secure way of reducing the risk of PCS developing is to get a clear diagnosis that the gallbladder is the organ causing the patients symptoms. - 20761
About the Author:
Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapy, back pain, orthopaedic conditions, neck pain, injury management and Physiotherapists in Bournemouth. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.
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