Introduction
The gallbladder serves to store and thicken the bile secretion needed for fat digestion, which is produced in the liver. If there are complaints due to gallstones (thickened bile secretion) or inflammation of the gallbladder, its removal may be necessary. A distinction is made between open surgery through an abdominal incision and the often preferred method of removing the gallbladder using the keyhole technique (laparoscopy).
The operation is associated with a hospital stay of several days. After the removal of the gallbladder, no permanent major restrictions are usually to be expected, provided that no complications arise. These are possible as with all operations, but are comparatively rare. It is important to follow the doctor’s instructions and to take it easy for a while after the operation.
Indications for a gall bladder resection
Removal of the gallbladder may become necessary if, for example, gallstones or inflammation of the gall bladder cause discomfort such as pain in the right upper abdomen, a feeling of fullness or nausea. The symptoms typically occur especially after eating fatty foods. Gallstones are often detected by chance during an ultrasound examination of the abdomen.
However, unless there are associated symptoms (also known as asymptomatic gallstones), surgery is not indicated. On the other hand, there are further indications for the removal of the gallbladder, for example, if the organ is torn after an accident or other injury. In addition, surgical removal is necessary for the more rare cancers of the bile ducts or the gallbladder.
Another indication for a gall bladder removal is when there is a connection between the gall bladder and another organ (for example the intestine). This is known as a gallbladder fistula, which must be removed together with the gallbladder. The actual surgical steps are similar in both procedures.
First, the gallbladder is searched for and a little bit freely prepared, i.e. it is brought from the surrounding tissue into an easily visible position. The artery that supplies the organ with blood is closed with a clip. The bile duct that connects the gallbladder with the other bile ducts is also closed to prevent a leakage of bile into the abdominal cavity.
The gallbladder can then be detached from the liver. The organ must then be recovered. In open surgery, the gallbladder can be removed directly.
In the keyhole technique, it is packed into a small recovery bag, which can then be pulled out, usually through the small incision at the navel. The individual layers of the abdominal wall are then closed layer by layer with sutures. After the operation, the patient usually first goes to a recovery room and can then be transferred back to the ward.
