Open Cholecystectomy with or without adhesiolysis
Gallbladder removal surgery, also acknowledged as a cholecystectomy, describes the procedure to remove gallbladder from the body. The gallbladder is a small, pocket-like organ in the upper right part of the abdomen. Its primary function is to store and transport a digestive enzyme called as bile that is produced by the liver. This enzyme is released to the intestine via bile duct to perform the digestion process.
A malfunction of gallbladder is due to the presence of gall stones inside the organ and the duct thereby blocking the flow of digestive enzymes. As the passage is prevented the enzymes gets accumulated causing swelling and pain. In advance conditions they can cause intense pain and jaundice( fever with yellow skin and eyes).
Cholecyctectomy or gallbladder removal is the common treatment available for gall stones. An open cholecyctectomy is referred by the surgeon when the patients have undergone previous surgeries with foremost scarring. Those patients with a bleeding disorder also require to undergo an open cholesystectomy. In some cases, the surgeon might find it difficult to view the internal organs through a laparoscope thereby converting it into an open cholesystectomy .
In Open cholecyctectomy, a large incision is made in the lower abdomen to reach and remove the gallbladder. The surgeon begins by a general anesthetic which pulls the patients to sleep but conscious and won’t feel the pain. A single large cut is made just below the ribs on the centre of the abdomen. This makes it visible to the surgeon the gall bladder and adjacent internal cavity and organs. The gall bladder is removed through the cut and the blood supply to the organ is tied up to prevent huge blood loss. Later the blood supply is divided. In some cases a x ray (cholangiogram ) is done to ensure there are no stones in the ducts. If x ray shows the presence of stones in the bile duct, the surgeon removes the ducts along with the bladder and closes the wounds.
Occurrence of scar tissue can lead to adhesiolysis surgery along with open cholesystectomy. Adhesions are found in majority of patients who have undergone preceding abdominal surgeries. It’s a self repairing system of the body to protect the internal organs. A band of tissues are developed around the locale undergone surgery. Most of the adhesion tissues formed is painless. While some scar tissues leads to fluid gathering causing pain due to compressed nerves. In such cases surgeon performs adhesiolysis to remove the band of affected tissues along with the appendectomy surgery performed. Generally they are removed when the surgeon detects the presence of adhesions in the abdominal cavity while performing appendectomy.
When comparing to laparoscopic cholesystectomy, open surgery might take few more days to recover as the cuts made in the abdomen are larger than the keyhole method. The patients can leave the hospital when they recover from the anesthetic effect. Patients have to follow proper medications and rest to have a faster recovery.