A Complete Analysis on the Cholecystectomy (Gallbladder Removal)

Digestion is vital in keeping a person healthy; the same goes for animals. When the food does not digest properly, it leads to considerable discomfort. The gland that is responsible for metabolism and appropriate digestion is the gallbladder. 

Do you know the gallbladder shape resembles a pear, which will sit beneath the liver's right side? Besides, it concentrates bile and assists in digesting the fluids provided by the liver. So, gallbladder obstruction can occur in the bile ducts.

If your animal is experiencing symptoms, your veterinarian may recommend Gallbladder removal surgery (cholecystectomy surgery). This is a relatively standard procedure usually performed laparoscopically, meaning it is done through small incisions in the abdomen.

We will discuss the gallbladder removal procedure, the cost of gallbladder surgery, complications, and more here. So please stick with us till the end!

Reasons for Cholecystectomy Surgery 

There are many conditions due to which gallbladder surgery becomes crucial. 

Gallstones (cholelithiasis)

For instance, the most common reason is gallstones, also curable with the medication. 

Inflammation of the Gallbladder (cholecystitis)

However, bile can be inflammatory if it causes a reaction internally to rupture the gallbladder. In this case, it becomes essential to clean up the gallbladder. 

Other Reasons 

Not only this, but some other situations require cholecystectomy surgery

• Pancreatitis
• Necrotizing cholecystitis
• Gallbladder mucocele
• Gallbladder cancer 
• Bile duct abnormalities etc. 

Cost of Gallbladder Surgery

There are a variety of factors that will affect the cost of gallbladder surgery. It can vary according to surgery type, the surgical clinic's location, and the surgeon’s experience. The cost of laparoscopic cholecystectomy typically ranges from $3,000 to $10,000.

Procedure for Gallbladder Removal Surgery

The pet should fast for the night before the Cholecystectomy surgery to ensure an empty stomach.

Preoperatively, blood tests will be conducted to confirm that all organ systems are functioning correctly. 

Before the surgery, the animal will receive pre-anesthetic medications, pain management drugs, and antibiotics to minimize surgical risks.

Instrument and Port Placement

• The surgeon secures the animal's limbs to prevent interference during the Gallbladder removal procedure.
• The abdomen is prepped by shaving the area, followed by aseptic draping over the surgical site.
• The vet makes an incision of approximately 1.5 cm through the rectus sheath at the umbilicus.
• A Kocher clamp grasps the linea alba at the umbilicus.
• Moreover, an incision is made into the linea alba using a No. 15 surgical blade, measuring about 1.2 cm in length.
• Using 0 polyglactin and a curved needle, two U-shaped sutures are placed on either side of the incision.
• The peritoneum is elevated between the clamps, and an 11mm blunt Hasson trocar is inserted into the abdominal cavity. The abdominal cavity is then inflated for better visualization.
• Then, the laparoscope is introduced into the abdominal cavity.

Dissection and Exposure

• The gallbladder fundus and adhesions are retracted using a lateral grasper.
• Then retract the infundibulum using a medial grasper.
• An L-hook is utilized in the lysing of the omentum to improve visualization of the gallbladder.
• The cystic artery and duct within Calot's triangle are dissected for a critical view. Once the anatomy is visualized, the gallbladder is dissected away from the liver.
• The gallbladder is removed from its bed using hook instruments and traction. Electrocautery is used to control bleeding.

Gallbladder Removal

• The gallbladder is lifted out using two 5mm graspers.
• The gallbladder is then placed into an endoscopic retrieval pouch.
• All surgical instruments are subsequently removed from the abdominal cavity.
• Any residual bile fluids at the gallbladder bed are thoroughly aspirated.
• A final inspection of the abdominal cavity is performed to ensure hemostasis and proper closure.
• Ultimately, the incisions are closed in the cholecystectomy dog using absorbable monofilament sutures.

Post-Operative Care After Cholecystectomy Surgery

Animals can survive without a gallbladder but require attentive care to handle their digestive system after a cholecystectomy or gallbladder removal surgery. 

Some complications can occur after dog gallbladder surgery. Therefore, regular veterinary check-ups are essential to monitor the pet's recovery, medications, and incision care and to regulate their diet for optimal digestion.

Gallbladder Surgery Complications 

Post-operative complications may vary between patients. If you notice any of the following symptoms in your pet after gallbladder removal, contact your veterinarian immediately:

• Lethargy or excessive tiredness
• Persistent or uncontrolled pain
• Unwillingness to eat or decreased appetite
• Vomiting or diarrhea
• Fever
• Signs of infection, such as redness, swelling, or discharge at the incision site

Medications

Certain medications are necessary for post-operative care based on the reasons for the gallbladder removal. 

The vet will prescribe short-term medicines like antacids to aid digestion and painkillers to control discomfort. Antibiotics might also be necessary to prevent any potential infection.

In cases where the animal's liver was part of the disease process necessitating gallbladder removal, your vet might prescribe medications to support liver function. Antioxidants such as milk thistle and S-Adenosylmethionine (SAM-E) are most common for maintaining pet liver health.

Incision Care

Post-surgery, the large incision on your pet's abdomen will require healing time and care. Your pet should wear an Elizabethan collar (e-collar) to prevent scratching or licking the wound. 

Regular cleaning of the wound is critical to prevent infection and promote healing. If you see any signs of infection, report to the vet immediately.

Feeding Instructions

Feeding your pet after a Cholecystectomy surgery requires certain precautions. A bland diet is often recommended initially to avoid straining the digestive system. Foods challenging to digest should be avoided in the early stages of recovery.

In the short term, your pet may require a diet low in fat and high in fiber to support digestion. After an initial period, your pet can transition back to a maintenance diet.

A long-term therapeutic diet may be necessary for some animals, especially those with concurrent diseases affecting their gastrointestinal tract or liver. This diet would aim to support digestion and liver function.

Regular Check-ups

Post-operative cholecystectomy cat check-ups are essential to monitor your pet's recovery and adjust medications or dietary requirements. 

These check-ups help ensure that your pet is healing properly and can return to normal activities safely.

Remember, the most important thing is to follow the advice of your vet and monitor your pet's behavior and symptoms closely. Swift communication with your vet about any changes or concerns will ensure the best possible recovery for your pet. This surgery is totally different than Brachycephalic obstructive airway surgery. Read out next article to know more about this surgery.