Laparoscopic (keyhole) cholecystectomy (removal of the whole gallbladder) is the standard of care for patients with symptomatic gallstones.
20% of the population has gallstones. If gallstones are removed without taking out the gallbladder, it will recur. Complications from gallstones include cholecystitis (infection of the gallbladder), cholangitis (blockage of the liver resulting in pain, fever and jaundice) and pancreatitis.
Laparoscopic cholecystectomy is a surgery which removes your gallbladder and gallstone under general anaesthesia. Straight forward gallstone cases usually take less than an hour. Complicated cases including infected gallbladder or patients with complications of gallstones may take up to 2 to 3 hours.
Patients are admitted on the same day of the surgery. Laparoscopic cholecystectomy may be done as a day procedure, meaning patients can go home on the same day or patients may stay overnight and are discharged the next morning.
After the gallbladder / gallstone surgery, patients will be able to walk around, have something to eat and able to walk to the bathroom. The wounds are closed with sutures and covered with waterproof dressings by the surgeon. Patients are allowed to shower and pat dry the wounds. Soaking in a bath and swimming are not ideal for the first few weeks after the surgery. Any heaving lifting and physical exercise is also discouraged initially.
Standard gallbladder / gallstone laparoscopic surgery uses 4 small incisions for the surgeon to insert a camera and instruments for the surgery. 3 of these incisions are around 5mm in size. The largest incision is the one just below the umbilicus (belly button). This incision is used for inserting the camera and where the gallbladder is taken out from the abdomen. The gallbladder is then sent to histopathology department. The pathologist will look at the gallbladder under the microscope to ensure that there are no malignant changes.
Other minimally invasive techniques include robotic cholecystectomy and single incision laparoscopic surgery. All these techniques are variations of the standard gallbladder / gallstone treatment surgery in Singapore. Currently, robotic surgery is relatively costly as compared to the standard laparoscopic technique.
Below are some common questions which patients often ask:
Q: What is the function of the gallbladder?
A: The gallbladder stores bile. The bile helps the digestive process by breaking up fats. It also drains waste products from the liver into the duodenum, a part of the small intestine.
Q: How come I have gallstones?
A: Gallstones are very common, about 20% of the population has gallstones. The liver produces bile. When bile is very concentrated, it precipitates and gallstones are formed.
Common complications are cholecystitis (inflammation of gallbladder), cholangitis (inflammation of bile duct) and pancreatitis (inflammation of pancreas). The risk of complications are 1 to 2% per year.
Q: My mother and sister has gallstones. Will I have gallstones too?
A: Gallstones are not hereditary.
Q: Can we use laser to treat my gallstones instead of surgery?
A: Laser is not used frequently in the treatment and management of gallstones symptoms. It is occasionally use when gallstones have dropped into the common bile duct and are too big to be removed. Laser can be used to break down these gallstones. Eventually, the gallbladder will still have to be removed.
Q: Do people live normally without the gallbladder?
A: Yes. 50% of patients may have loose motion for up to 6 months, usually most significant during the first 1 to 2 weeks. After 3 to 6 months, they are back to their usual self. Find more answers to life after your laparoscopic gallbladder / gallstone surgery through our blog.
Q: Do I have to change my diet after gallbladder surgery?
A: Some patients may experience loose bowel motion after gallbladder surgery. That group of patients may benefit from having a low-fat diet initially.
Q: How long will I take to recover after surgery?
A: Generally patients come in on the same day of surgery. They may go home on the same day or stay overnight and are usually discharged the next day.
After the surgery, they can walk around, go to the bathroom on their own, eat and drink. They are allowed to shower.
Medical certificate is given for about 2 to 4 weeks.
Q: How long is the gallbladder / gallstone treatment and surgery?
A: Straight forward surgery usually takes the surgeon half an hour to an hour. More difficult ones will take around 2 hours.
Q: Should I have my gallbladder operation?
A: For symptomatic patients, the answer is yes.
For asymptomatic patients (no symptoms), the answer is generally no, unless
• Gallstones >2cm
• Polyps / stones increasing in size (> 1 to 2 cm)
• Fully consented patients who wants their gallbladder surgery
If you think you have developed some gallstone symptoms, reach out to us for an appointment.
