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Laparoscopic Cholecystitis

What is a Cholecystitis ?

Cholecystitis is inflamation of Gall Bladder

Gall Bladder is a pear shaped organ situated just below liver in right upper abdomen. It functions as a temporary storage of bile of about 60ml which is squirted out when an individual has an oily meal.

When does Gall Bladder get inflamed?

When the composition of bile changes gall stones are formed.

These stones block the mouth of gall bladder and cause distension of the gall bladder. This causes pain. If infection sets in this gall bladder then complications may occur. Presence of stone over a long period of time is associated with cancer of the gall bladder.

What are the complications of Cholecystitis?

A distended gall bladder forms mucocoel of gall bladder.

An infected mucocoel gives rise to empyema of gall bladder.

The infected gall bladder may rupture into intestine or liver.

Migration of stone from the gall bladder into the common bile duct leads to Jaundice. If this stone blocks the ampula of vater then pancreatitis may result.

What are the symptoms of Cholecystitis?

The patient may have pain vomiting nausea dyspepsia acidity or fever. The patient may present with jaundice or inability to tolerate oral feeds. If the pancreatitis has set in, then the pain to left side of abdomen and back may be a symptom.

What is the treatment of Cholecystitis?

Cholecystectomy performed Laparoscopically is the gold standard, though it may be done through open incision or through robotic surgery or SILS. In the event of stone blocking the common bile duct patient may require ERCP.

What tests need to be performed?

  • Blood Sugar
  • Creatinine
  • Urine routine and microscopy
  • LFT
  • Xray chest
  • ECG
  • Sonography of Abdomen

If the stone is suspected in common bile duct then MRCP is performed

If a stone is found in common bile duct then ERCP with stenting needs to be performed if the possibility of spontaneous passage is low.

What are the complications of Gall Bladder surgery?

The complication in a Gall Bladder surgery can be Bleeding, Infection, Slippage of stone into CBD or Leakage of bile.

The anesthesia may cause certain complications too.

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