Dr. Bernard Beldholm M.B.B.S B.Sc (Med), FRACS (Specialist Surgeon)
117 Mt Pleasant St Ph:(02) 49319299
Maitland, NSW 2320 Fax:(02) 49329132
Laparoscopic Gallbladder Surgery
abdominal cavity to lift the abdominal wall clear of the liver, gallbladder,
What is it? small intestine, stomach and other organs. The GB is identified and careful
About one adult in every 10 dissection of the structures is performed. Dr. Beldholm’s usual practice is to
has gallstones. In people perform a cholangiogram (X-ray of the bile ducts). A special tube is inserted
who have symptoms caused into the cystic duct, X-ray dye is injected, and X-rays are taken. This will
by gallstones, removal of the demonstrate if there are any GB stones in the ducts and will confirm that the
gallbladder is usually the correct ducts are being clipped and cut. After the cholangiogram the GB is
best treatment. In people removed from its liver attachment and taken out through the umbilical port.
with complications due to Dr. Beldholm does not usually leave a drain behind. The incisions are closed
gallstones, prompt treatment with absorbable stitches (these do not need to be removed).
is important. The most
common way to remove the
GB is by laparoscopic
Symptoms and Diagnosis
When the amounts of bile and other fluids inside the gallbladder (GB)
become unbalanced, some of the chemicals solidify and form gallstones.
Most gallstones are made primarily of cholesterol.
If the gallstones stay deep within the GB, they may not cause major
problems. If the gallstones move and block ducts, bile can back up, causing
symptoms and leading to infections and diseases of the GB, liver or pancreas.
Symptoms from your GB usually occur after a meal and include;
Steady, severe pain in upper abdomen (GB Colic) this often wakes Effects of surgery and side effects
the person at night In Dr. Beldholm’s experience serious problems are uncommon,
Pain may go through to the back however can happen. Complications related to GB surgery include;
Bloating Risks in common to all operations such as anaesthetic and
Nausea cardiovascular complications
Vomiting Wound related; infection, bad scarring, keloids and incisional
Symptoms may settle, but they tend to come back if left untreated. hernias
Re-operation for internal bleeding, bile leaks or infection
Your GB is not essential for healthy digestion. Once your GB is removed,
bile will still flow (as it always has) from the liver to the small intestine. Injury to organs close to GB (small bowel, stomach, liver etc)
Common Bile duct injury; this is potentially the most serious
Laparoscopic VS Open Cholecystectomy complications after GB removal. It is reported to occur 3-5 out of
Laparoscopic (keyhole) surgery is now the standard method for every 1000 operations. If this occurs, you may get lifetime
removing the GB. The benefits of laparoscopic surgery are many and problems that are difficult to treat
include (compared with open surgery); Gas embolism (a bubble of carbon dioxide gets into the blood
Less discomfort after surgery stream), this can be life threatening but is very rare
Less time in the hospital There may be some change in bowel habits and eating after this
A recovery of days instead of weeks operation, this is associated with the post-cholecystectomy
Small incisions instead of a large painful incision syndrome. This has been reported in up to 10 percent of patients.
Small scars instead of a long scar It can range from vague symptoms to more severe symptoms
Even though you may expect keyhole surgery, sometimes it is including; crampy abdominal pain, steatorrhoea and bloating.
necessary to convert the keyhole surgery to open surgery. This Recovery
happens rarely in Dr. Beldholm’s experience. Open surgery is safe After surgery, there may be some minor discomfort in your abdomen
and effective. Converting your operation into an open operation is not and there may be some right shoulder pain. This is normally
a complication; it is done to protect the patient. The decision to controlled with simple painkillers such as paracetamol and/ or
convert to open surgery should be considered to be sound judgement. ibuprofen. You may have some fluids a few hours after surgery and a
full diet 6 to 8 hours after surgery. In Dr. Beldholm’s experience,
A patient may be very disappointed that he or she had open surgery most patients go home within 24 hours and are back to normal after
instead of keyhole surgery, but open surgery is done in the interests one week. If you have an open operation, the recovery may take up to
of the patient’s safety and well-being. 6 weeks and you may have to stay in hospital for up to 1 week.
Technique for Laparoscopic GB Operation You may have some gas pains and other discomfort while your
Dr. Beldholm usually uses 4 small cuts to insert the necessary instruments. digestive system returns to normal. Eat a low fat healthy diet that was
These cuts range from 5 to 12mm. Carbon dioxide gas is blown into the easy to digest before your gallbladder surgery.
This pamphlet is intended to provide you with information. It is not a substitute for
advice from your surgeon and does not contain all known facts about this subject.
Write down any questions you want to ask, Dr. Beldholm will be more than happy
to answer any questions you may have.