Schematic diagram of liver, pancreas and bile ducts - showing location of gall bladder
As mentioned earlier, the bile duct is a tube which runs from the liver to the bowel and the gallbladder, which sits on the under surface of the liver and empties into the bile duct.
The bile duct is a crucial piece of tubing and it is important to preserve this during any surgery to the gallbladder. For this reason an x-ray of the bile duct is often carried out at operation. There is a low risk of injury to the bile duct. The published data suggests a risk of approximately 0.1 - 0.2% (i.e. 1-2 in a 1000 operations). If this were to happen then the bile duct would need to be repaired by 'open' surgery.
In Professor Karanjia's personal series (in Guildford) there has never been a bile duct injury. In the situation of such an injury occurring immediate repair would be carried out by Professor Karanjia who is an experienced liver cancer, bile duct and pancreatic surgeon.
If you were one of the 1% that required conversion to the open operation then it is likely that you would spend 5 to 7 days in hospital.
The incision is often quite painful but this can be controlled with a pain killer called Voltarol which is given by suppository and by Pethidine (morphine) injections.
In the event of open surgery you will not be able to drink or eat immediately post-operatively. During the early post-operative phase you will have a drip to provide your body with fluids. There will be a graded re-introduction of oral fluids, and eventually food, over the next few days, according to your progress. However, once you are discharged from hospital you should be able to eat a completely normal diet.
There is often quite a lot of bruising around the scar and this can last for several weeks. The wound will be closed with clips and these will need to be removed approximately 10 days from the date of the operation. This will be arranged for you. You may shower over the dressing approximately 3 days after the operation and if the dressing comes off the wound can be left open. Most patients like to keep a dressing on the wound so as to keep the clips away from contact with clothing.
If you need 'open' surgery you are likely to need a month off work. It is likely that you will need at least three weeks off before you can go back to driving and you should be certain that you are able to carry out an emergency stop before you start driving. In addition, you should check with your car insurance company that you are covered to resume driving.
Most patients require a month before they can start gentle exercise. It is important to start very gently and slowly build up your level of exercise depending on symptoms from the wound.