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Cholecystectomy and exploration of the bile duct
6-minute read
What are common bile-duct stones?
Common bile-duct stones are gallstones that move out of your gallbladder and get stuck in your common bile duct, which is a tube that connects your gallbladder and liver to your intestines. Gallstones are ‘stones’ that form in your gallbladder. They are common and can run in families.
Your liver produces a fluid called bile that is concentrated by, and stored in, your gallbladder.
When you eat food, your gallbladder empties bile into your intestines to help digest fats. Stones can develop in bile, particularly if you eat a diet rich in fat.
What are the benefits of surgery?
You should be free of pain and able to eat a normal diet. Surgery should also prevent the serious complications that common bile-duct stones can cause.
Are there any alternatives to surgery?
An ERCP (endoscopic retrograde choledocho pancreatogram) is a procedure to examine your bile duct using a flexible telescope and dye (colourless contrast fluid).
It is possible to dissolve the stones or even shatter them into small pieces but these techniques involve unpleasant drugs that have side effects and a high failure rate.
Antibiotics can be used to treat any infection of your gallbladder and common bile duct. Eating a diet low in fat may help to prevent attacks of pain.
What does the operation involve?
The operation is performed under a general anaesthetic and usually takes 1 to 2 hours.
Your surgeon will first need to find out where the stones are in your common bile duct.
If your surgeon finds any gallstones in the duct, they will try to remove them through the cystic duct or the common bile duct. Various techniques can be used, including a wire basket or a tube with an inflatable balloon at the end (balloon catheter).
Your surgeon will remove your gallbladder. They will free up and secure your gallbladder duct (cystic duct) and artery, separate your gallbladder from your liver, and remove it.
How can I prepare myself for the operation?
If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.
Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.
Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.
Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.
What complications can happen?
Some complications can be serious and can even cause death.
General complications of any operation
- bleeding
- allergic reaction to the equipment, materials, medication or dye
- infection of the surgical site (wound)
- blood clot in your leg
- blood clot in your lung
- chest infection
- developing a hernia in the scar
Specific complications of this operation
Keyhole surgery complications
- gas embolism
- damage to structures such as your bowel, bladder or blood vessels
- conversion to open surgery
- surgical emphysema (crackling sensation in your skin caused by trapped carbon dioxide gas)
- developing a hernia near one of the cuts
Bile duct exploration complications
- leaking of bile after the tube is removed
- infection of your skin around the tube
- difficulty removing the tube
- retained stones in your common bile duct
- stones forming again in your common bile duct
- narrowing of your common bile duct
Cholecystectomy complications
- leaking of bile or stones
- bowel injury
- inflammation of the lining of your abdomen
- bowel injury
- continued bowel paralysis (ileus), where your bowel stops working for more than a few days
- serious damage to your liver or its associated blood vessels
- continued pain
- needing to go to the toilet more often
- tissues can join together in an abnormal way
Consequences of this procedure
- pain
- scarring of your skin, which may be unsightly
How soon will I recover?
You should be able to go home after 1 to 2 days if you had keyhole surgery or after 4 to 5 days if you had open surgery.
You should be able to return to work after 3 to 4 weeks, depending on how much surgery you need and your type of work.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.
You should make a full recovery and be able to return to normal activities and eat a normal diet.
Summary
Gallstones are a common problem. An operation to remove your gallbladder and any stones in your common bile duct should result in you being free of pain and able to eat a normal diet.
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