Download Tension-free Vaginal Tape (TVT) – Information for Patients

General Surgery Directorate
Information for Patients
Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy is the name of the operation to remove your gallbladder and
gallstones. The gallbladder is a small, pear-sized pouch that sits below the liver, on the right
side of the abdomen. Its role is to store and concentrate bile; a digestive fluid that helps to
break down the fat in food.
Liver
Gallbladder
Bile Duct
Stomach
Bile is made up of cholesterol, bile salts and other pigments. Sometimes these substances fall
out of balance, which can result in gallstones forming within the gallbladder. Gallstones occur
in many patients without causing symptoms. However in some people, gallstones can cause
pain (biliary colic) or inflammation of the gallbladder (cholecystitis) or pancreas (pancreatitis).
Treatment
The best way to treat these problems is to remove the gallbladder. Previously, this was done
by making a cut in the top of the abdomen and removing the gallbladder. However, with
advances in technology, we are now able to perform this procedure in the majority of patients
using ‘key-hole’ (laparoscopic) surgery.
The operation
You will be asleep and pain free, under general anaesthetic, during the operation. Cuts will be
made around the belly button and just below the rib cage on the right hand side. There will 4
cuts in total, each around 1 cm in size. Through each of these cuts, surgical instruments are
passed; the abdomen is filled with carbon dioxide gas and a telescope attached to a small
camera is used to allow the surgeon to see inside. The gallbladder can then be removed.
Rarely, the gallbladder cannot be removed safely using key-hole surgery, and has to be
removed by the traditional method, involving a larger cut to the upper abdomen.
Benefits
Once the gallbladder is removed, symptoms should settle permanently. The procedure and
recovery time are typically short, and if your health is generally good, you should be expect to
go home the same day. We do not expect that there will be long-term side effects.
Laparoscopic Cholecystectomy
Version 3 November 2007, 2010, 2013. Next Review Date 30 November 2016
Page 1 of 4
Information for Patients
Risks
Based on an audit undertaken at our Trust:
A) Risks specific to cholecystectomies:




Wound infection – 1% (1 in 100 people)
Key-hole needing to be converted to open - 1% (around 1 in 100 people)
Leakage of bile – 0.3% (1 in 330 people)
Bleeding – 0.2% (1 in 500 people)


Injury to the common bile duct – 0.1% (1 in 1000 people)
Injury to organs or blood vessels in the abdomen – 0.1% (1 in 1000 people)
B) In common with all surgeries, there are also slight risks concerning:
 Anaesthetic risks
 Blood clots in the legs, or occasionally the lungs
 Small risk of death – Worldwide, the risk of death after cholecystectomy is estimated at
1 in 800
This may seem a relatively high risk; however, the operation is generally a safe procedure.
The risks of complications are increased in certain patients; for example, in people who suffer
from other medical conditions such as heart or kidney disease.
Preparing For the Operation
To reduce the risks of complications, patients can:


Lose weight – this decreases anaesthetic risk and the chances of getting blood clots.
Your surgeon may recommend that you take a very low calorie diet for 1-2 weeks prior
to your surgery.
Give up smoking - reduces risk of blood clots and generally improves health.
Pre-assessment clinic
A specialist nurse will assess your health and prepare you for surgery. You will also be told if
there are any medications that should be stopped prior to surgery.
On the day of surgery
If you feel unwell or are suffering from any health conditions, it is important to let us know, as
it may be more beneficial to you to delay the surgery until you have recovered. To help
reduce blood clots, you will be given an injection into the tummy and some tight stockings to
wear. An anaesthetist will come and assess you and will be able to answer any questions you
may have. You cannot eat or drink anything 6 hours before the operation, so that the stomach
is empty for your operation. A small tube (cannula) will be placed in your arm to give you
medication to put you to sleep. You will be monitored throughout your operation by an
anaesthetist.
After the operation
When you wake up, you may feel drowsy, sick and complain of a sore throat. You may
experience abdominal bloating and pain in your shoulders. These are normal side-effects and
should pass within a few days. During recovery some abdominal bruising and discomfort may
Laparoscopic Cholecystectomy
Version 3 November 2007, 2010, 2013. Next Review Date 30 November 2016
Page 2 of 4
Information for Patients
be expected, but this should settle with simple pain killers. It is important to mobilise as soon
as possible as this helps to speed up recovery. Recovery varies from person to person, but
>50% of patients are well enough to leave hospital on the same day of the operation. You will
be given any medication you require, including pain relief, before you leave.
Frequently Asked Questions
Are there any alarm symptoms I should look out for after my surgery?
Some discomfort is to be expected in the first 3 days after surgery, requiring regular
painkillers such as paracetamol and codeine. You should be concerned if your pain is
suddenly worse or not controlled without stronger painkillers. You should also seek medical
advice if you have a persistent temperature or a yellow discolouration of the whites of the
eyes or skin (jaundice). If you are concerned, please contact your GP for an urgent
appointment or the admissions unit of the hospital where you had your surgery.
How long will I take to recover?
This varies from person to person, but usually takes 1-2 weeks. It may take you some time to
build back up to your normal level of activity. We advise that you avoid heavy lifting and any
strenuous exercise for the first three weeks.
Can I drive as normal?
As a general rule, you should avoid driving until you feel able to perform an emergency stop
without hesitation and too much discomfort. This can normally take up to two weeks.
When can I go back to work?
This depends on how quickly you recover. It also depends upon the nature of your work; for
example, if it involves heavy lifting or strenuous activity, you may need more time off.
Generally, it may take up to 3 weeks before you are able to start work.
Will I need my stitches to be removed?
We normally use stitches that dissolve, so you will not need to have them removed.
Occasionally, glue is used to close the small wounds, which will come off with time.
Can I live a normal life without my gallbladder?
Your liver will still produce the bile required to help digest your food, so you can lead a normal
life without a gallbladder. You may experience some bloating or diarrhoea if you’ve eaten
certain foods, for example spicy or fatty meals. If this occurs, you may wish to avoid those
foods in the future.
Will I need further follow-up and treatment from my surgeon?
Generally speaking, you will not need to be seen again by your surgeon. However, if you do
need to be seen again, you will be given an appointment time at discharge.
If you would like more information, or you have any questions, the following
Information websites may be useful.
http://www.nhs.uk/conditions/Laparoscopiccholecystectomy/Pages/Introduction.aspx
http://www.patient.co.uk/health/cholecystitis
http://www.patient.co.uk/health/gallstones-leaflet
Laparoscopic Cholecystectomy
Version 3 November 2007, 2010, 2013. Next Review Date 30 November 2016
Page 3 of 4
Information for Patients
Our commitment to confidentiality
We keep personal and clinical information about you to ensure you receive appropriate care
and treatment. Everyone working in the NHS has a legal duty to keep information about you
confidential.
We will share information with other parts of the NHS to support your healthcare needs, and
we will inform your GP of your progress unless you ask us not to. If we need to share
information that identifies you with other organisations we will ask for your consent. You can
help us by pointing out any information in your records which is wrong or needs updating.
Additional Sources of Information:
Go online and view NHS Choices website for more information about a wide range of health
topics http://www.nhs.uk/Pages/HomePage.aspx
You may want to visit one of our Health Information Centres located in:


Main Entrance at Birmingham Heartlands Hospital Tel: 0121 424 2280
Treatment Centre at Good Hope Hospital Tel: 0121 424 9946
or contact us by email: [email protected].
Dear Patient
We welcome your views on what you liked and suggestions for how things could be improved
at this hospital. If you would like to tell us and others about your experience please make your
comments through one of the following sites:



NHS Choice:Patient Opinion:I want great care:doctor)
www.nhs.uk
www.patientopinion.org.uk
www.iwantgreatcare.org (Here you can leave feedback about your
Be helpful and respectful: think about what people might want to know about this hospital or
how your experiences might benefit others. Remember your words must be polite and
respectful, and you cannot name individuals on the NHS Choice or Patient Opinion sites.
If you have any questions you may want to ask about your condition or treatment, or
anything you do not understand or wish to know more about, write them down and
your doctor will be more than happy to try and answer them for you.
Laparoscopic Cholecystectomy
Version 3 November 2007, 2010, 2013. Next Review Date 30 November 2016
Page 4 of 4