Background:

–Gallbladder is an organ situated on the posterior side of the liver in the right hypochondrium. The role is to stock and concentrate the bile during the fasting periods of the day.

–Symptomatology of gallstones is usually represented by episodes of biliary colic which are pains in the right hypochondrium with nausea or vomiting. The biliary colic is produced when the gallstone migrate to the duodenum after the contraction of the gallbladder with a possible blockage of the cystic duct or common bile duct by the stone.

-The usual radiologic exam to investigate this pathology is represented by the abdominal echography.

-The surgery is performed by laparoscopy (with small incisions) under general anesthesia.

-It is possible to live normally without a gallbladder. After the procedure, the bile drains from the liver through the ducts, directly into the small intestine and a specific diet is usually not necessary. On the other hand, the more frequent flow of bile in the small intestine can cause diarrhea which is usually self-limiting. A low fat diet is recommended until the time of surgery, to avoid the risk of migration of the gallstones.

Classic postoperative course:

For elective cholecystectomy, the postoperative course is usually simple and the patient leaves the Unit on Day1.

•Day 0 – After the surgery, the patient can drink water and in the evening the oral intake is authorized. In case of One Day surgery, the patients can return home at the end of the day, if is in good general status.

•Day1 – After a night at the hospital, if the patient presents a correct clinical condition, parameters within physiological standards, oral refeeding and resumed intestinal transit, discharge is authorized.

Complications:

-Infections on the postoperative wounds

-Vascular injuries

-Bile leakage from the cystic duct

-Injury to the bile duct

-Injury to the colon, small bowel

Complications of gallstones:

-Acute cholecystitis (inflammation of the gallbladder- due to the mechanical irritation of the stones).

-Acute pancreatitis (inflammation of the pancreas- due to the gallstone migration)

 -Angiocholitis (infection of the intra and extrahepatic bile ducts due to a blockage of a stone into the bile duct)

-Mirizzi syndrome (compression of the bile duct by a gallstone placed in the vesicular infundibulum)

-Gallstone ileus (creation of a fistula between the gallbladder and the duodenum with migration of a lithiasis who produce an mechanical occlusion of the small intestine)

-Gallbladder cancer