Bile duct injury Injury to the bile duct Injury to the main bile duct is the major risk during cholecystectomy. This occurs in about one in every 300 operations so is rare but does need a major operative repair to fix the problem. Surgeons are very aware of this and try very hard 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.
Loose stools A level of diarrhoea can be experienced in a small group of patients who have had a cholecystectomy. Typically this is a minor effect but at times medication is required to control it.
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 frequent complications (one in a hundred to one in ten thousand) are temporary difficulties with speaking and breathing, headaches, muscular pains, damage to lips, tongue and teeth and sore throat.
Side effects which are very uncommon but very important with a risk of less than 1 in 10,000 could be long-lasting damage to blood vessels and nerves, failure of the liver or kidneys, injury to the eyes, brain, laryngeal or lung damage, serious allergic reactions and death. These latter side effects are very rare and depend on the other medical conditions the patient has.
The benefits of cholecystectomy via the laparoscope The benefits of laparoscopic cholecystectomy have meant that surgeons have changed almost completely from open operation. A speedier recovery time, lower infection risk, reduced post-operative pain and very limited scarring are the main reasons this operative technique is preferred. After 24 hours most patients are now mobile and able to go home, returning to work by seven days. Laparoscopic cholecystectomy is no longer a new operation and surgeons are skilled at doing this.
How to deal with problems A fever or infection discharging from a wound is an acute problem which sometimes presents and patients should initially contact their general practitioner for advice. Referral to the hospital surgeons may be necessary and the doctor will make the necessary calls should this be required. If local urgent medical consultation is not available from their general practitioner then attendance at the local Emergency Department should be sought.
PCS or Postcholecystectomy Syndrome
Post cholecystectomy syndrome (PCS) describes a group of symptoms which can present after cholecystectomy. The typical symptoms originally attributed to the gallbladder may continue after the operation or new symptoms can develop which would normally be thought to be due to gall bladder problems. This syndrome will also cover symptoms brought on by gallbladder removal itself. The cause of PCS is thought to be an alteration in the bile flow because the reservoir for bile, the gallbladder, has been lost. There may be an increased flow of bile into the upper digestive tract, adding to inflammation of the oesophagus and stomach. Secondly this may have an effect lower down in the digestive tract, causing diarrhoea and sharp abdominal pains.
Typical average prevalence of PCS is 10 to 15 percent of cases of cholecystectomy, with attentive communication and questioning required both to explain the potential difficulties pre-operatively and to elicit the somewhat subtle symptoms later. Overall opinion is that the more securely the diagnosis is made initially the less likely PCS is to occur. - 14130
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.
Loose stools A level of diarrhoea can be experienced in a small group of patients who have had a cholecystectomy. Typically this is a minor effect but at times medication is required to control it.
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 frequent complications (one in a hundred to one in ten thousand) are temporary difficulties with speaking and breathing, headaches, muscular pains, damage to lips, tongue and teeth and sore throat.
Side effects which are very uncommon but very important with a risk of less than 1 in 10,000 could be long-lasting damage to blood vessels and nerves, failure of the liver or kidneys, injury to the eyes, brain, laryngeal or lung damage, serious allergic reactions and death. These latter side effects are very rare and depend on the other medical conditions the patient has.
The benefits of cholecystectomy via the laparoscope The benefits of laparoscopic cholecystectomy have meant that surgeons have changed almost completely from open operation. A speedier recovery time, lower infection risk, reduced post-operative pain and very limited scarring are the main reasons this operative technique is preferred. After 24 hours most patients are now mobile and able to go home, returning to work by seven days. Laparoscopic cholecystectomy is no longer a new operation and surgeons are skilled at doing this.
How to deal with problems A fever or infection discharging from a wound is an acute problem which sometimes presents and patients should initially contact their general practitioner for advice. Referral to the hospital surgeons may be necessary and the doctor will make the necessary calls should this be required. If local urgent medical consultation is not available from their general practitioner then attendance at the local Emergency Department should be sought.
PCS or Postcholecystectomy Syndrome
Post cholecystectomy syndrome (PCS) describes a group of symptoms which can present after cholecystectomy. The typical symptoms originally attributed to the gallbladder may continue after the operation or new symptoms can develop which would normally be thought to be due to gall bladder problems. This syndrome will also cover symptoms brought on by gallbladder removal itself. The cause of PCS is thought to be an alteration in the bile flow because the reservoir for bile, the gallbladder, has been lost. There may be an increased flow of bile into the upper digestive tract, adding to inflammation of the oesophagus and stomach. Secondly this may have an effect lower down in the digestive tract, causing diarrhoea and sharp abdominal pains.
Typical average prevalence of PCS is 10 to 15 percent of cases of cholecystectomy, with attentive communication and questioning required both to explain the potential difficulties pre-operatively and to elicit the somewhat subtle symptoms later. Overall opinion is that the more securely the diagnosis is made initially the less likely PCS is to occur. - 14130
About the Author:
Jonathan Blood Smyth is the Superintendent of Physiotherapists at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for physiotherapists in Brighton visit his website.
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