Main bile duct injury The greatest risk during cholecystectomy is injury to the main bile duct. Once in every three hundred operations is the typical frequency of this problem. As it requires major surgery to fix this problem all surgeons are acutely aware of it and make every attempt to avoid it.
Other side effects in the abdomen There are other side effects from cholecystectomy such as a leaking of the bile but these are not usually apparent until after discharge of the patient. Patients should consult their general practitioners at once if they develop a yellow colour to the skin (jaundice) or find they are having steadily increasing abdominal pain.
Diarrhoea A small percentage of patients notice their bowels become looser after cholecystectomy. This is usually very minor but occasionally medication is needed to control this effect.
Deep vein thrombosis (DVT) DVT is a possible problem after cholecystectomy but is uncommon. If a patient is at particular risk (having had a thrombosis before or if they are taking the contraceptive pill) then they should tell the surgeon about this and special precautions will be taken to reduce the risk. Moving the legs and feet as soon as possible after the operation and walking about early all help to stop thrombosis occurring.
General anaesthetics ” the risks A general anaesthetic comes with some risks which are usually low but may be more likely in people with other medical diseases:
Common temporary side-effects (risk of 1 in 10 to 1 in 100) include bruising or pain in the area of injections, blurred vision and sickness (these can usually be treated and pass off quickly.
Less common side effects of 1 in a hundred to 1 in 10,000 risk can be breathing and speaking problems which are short term, headache, pains in the muscles, sore throats and teeth, tongue and lip damage.
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.
What is the benefit of laparoscopic cholecystectomy? Surgeons have changed from traditional open cholecystectomy to laparoscopic cholecystectomy because it has several benefits. The main ones are minimal scarring, less pain after the operation, a reduced risk of infection and a faster recovery time. Most patients are now able to be up and about and home within 24 hours of the operation and should be able to return to work within 7 days. Laparoscopic surgery is no longer new and the consultant will have performed many of these operations.
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.
Post cholecystectomy syndrome (PCS)
PCS or postcholecystectomy syndrome includes a series of symptoms such as ongoing symptoms after the operation which were thought to be due to the gallbladder or new symptoms typically classed as related to that organ. There are also symptoms caused by the removal of the organ itself. Changes in bile flow once the gallbladder, normally the bile reservoir, has been removed are thought to cause the difficulties. The upper digestive tract can suffer inflammation of stomach and oesophagus due to increased flow of bile, with the lower tract suffering from colic-like abdominal pains and diarrhoea.
About 10-15% of cholecystectomy patients may complain of such symptoms and careful discussion of potential post-operative complications is necessary for PCS problems to be identified. The most secure way of reducing the risk of PCS developing is to get a clear diagnosis that the gallbladder is the organ causing the patients symptoms.