Cholelithiasis is the formation of stones in the gall bladder commonly known as gallstones. Treatment for cholelithiasis usually involves surgical removal of the gallbladder. It is done if it has already affected the functionality of the gall bladder and symptoms can no longer be managed. Since the stones are the cause of all the symptoms, it is best to remove the source.
The surgical procedure is called cholecystectomy. It could either be via laparoscopy (non-open surgery) or just the traditional cholecystectomy (open surgery).
Laparoscopic cholecystectomy makes use of a laparoscope, a small, thin tube that will go through four small puncture wounds in the abdomen.
Traditional cholecystectomy is done through a long, transverse, right subcostal incision. A T-tube is needed to be inserted into the common bile back to make sure that the bile drainage is not obstructed. It is placed there for several days after the operation. However, according to Brunner and Suddarth (Textbook of Medical-Surgical Nursing, p.1133), T-tube insertion for open surgeries is now uncommon; it is used only in the setting of a complication such as retained common bile duct stone.
The difference between the two procedures is that patients with open cholecystectomy are hospitalized longer than those who undergo a laparoscopic cholecystectomy. Usually the patient stays 2-3 days in the traditional surgery compared to only 24 hours or even less in the laparoscopic surgery. Also, open type of surgery causes incision pain, making the patient have difficulty in coughing and deep breathing, two important post operative exercises. Paralytic ileus is prevented in laparoscopic surgery where it is common in the open type.
According to the National Institute of Health, before undergoing the surgery, the patient will need to be under a series of medical tests and be taught what not to do or eat. The doctor will have to do several blood tests such as CBC, electrolytes and kidney tests. A series of X-rays are also done on the gallbladder. To some patients, Chest x-ray and ECG may be a requirement.