When you are fully awake after your operation, you can start eating and drinking what you want, starting with plain food and if this is well-tolerated then you can resume a normal diet. Some people feel nauseous after a general anesthetic but this is usually short-lived and can be helped by anti-sickness medication. To begin with you can take sips of water and then increase from fluids to solids. You may have a drip in your arm, which will come out soon after you recover from the anesthetic. How will my diet be affected by a laparoscopic cholecystectomy? Once the gallbladder is taken out all the instruments are removed from the abdomen and the carbon dioxide gas is allowed to escape before the incisions are closed with dissolving sutures. These clips stay in your body and do not cause any problems. Small clips are placed to block off the tube leading from the gallbladder to the other bile ducts (cystic duct) and the arteries leading to the gallbladder. The surgeon then puts instruments such as forceps and scissors into the other ports to help remove the gallbladder (figure 3). Carbon dioxide is then blown into the abdomen (insufflated) to lift the abdominal cavity away from the liver, gallbladder, small bowel, stomach and other organs. Hollow tubes called ports are inserted through the other small incisions. The telescope (‘laparoscope’) is passed into one of the small incisions to allow the surgeon to see inside the abdomen. There are usually three or four small cuts (incisions) made in the abdomen (figure 2), however the number of the cuts and their positions may vary between patients. It is necessary to remove the gallbladder as well as the gallstones as otherwise the gallstones will recur. This is commonly known as keyhole surgery and is safe and effective for most patients who have symptoms from gallstones. Laparoscopic cholecystectomy is the surgical removal of the gallbladder using a laparoscope (a tube like instrument). For this reason, it is recommended that patients with symptomatic gallstones have their gallbladder removed. Once you develop symptoms relating to gallstones, then it is likely that you will go on to develop complications if not treated. Patients who develop complications almost always have a preceding history of biliary pain. It is rare for patients that are asymptomatic to present with life threatening complications. It is estimated that 1/4 patients with asymptomatic gallstones will develop symptoms over 5-10 years. If this occurs the person may become jaundiced (yellow) and require urgent treatment to remove the offending stone. Sometimes stones may travel into the bile ducts and cause a blockage (referred to as choledocholithiasis). The classic symptoms attributed to gallstones include pain, bloating, nausea and/or vomiting. Only a minority of patients with gall stones develop symptoms. It is very rare that we can identify why any one particular person develops gallstones. Occasionally they develop after long periods of illness, and sometimes people with certain blood disorders develop them. There are also some medications used to reduce cholesterol that predispose to the development of gallstones. They are more common in women taking estrogen either as the oral contraceptive or hormone replacement therapy. They are more common in women than men and there is a tendency to develop them in pregnancy. They tend to occur in people who are overweight or obese, and in those who lose weight rapidly. They tend to develop in middle age (40 years and older) but are sometimes seen in very young people. There are many different reasons why people develop gallstones. It is estimated that around 20% of people will develop gallstones in their life time. Gallstones may form in any part of the biliary system, but most commonly in the gallbladder. The gallbladder stores bile, which is a fluid that helps to emulsify fat and facillitate absorption.īile produced in the liver flows through bile ducts and into the first part of the small intestine (gut). The gallbladder is a small pear-shaped organ that is attached to the underside of the liver.
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