Laparoscopic Cholecystectomy In Children

What you should know

Laparoscopic cholecystectomy is surgery to remove your child's gallbladder. The gallbladder stores liquid called bile. Bile helps your child's body digest fat. After surgery, your child's bile ducts will widen to hold the bile once held by his gallbladder. During the surgery, small incisions are made in your child's abdomen. A small scope and surgical tools are inserted through the incisions. A scope is a flexible tube with a light and camera on the end.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Risks

• Your child may have pain in his abdomen and around his incisions. Any carbon dioxide gas that remains in your child's abdomen can rise and cause neck and shoulder pain. There is a small risk that your child's bile duct, liver, small intestine, or other organs could be damaged during surgery. Your child could bleed more than expected or get an infection. Your child's pancreas could become inflamed, which could cause abdominal pain, bloating, or vomiting. Bile or bowel movement in his abdomen can cause a severe infection or abscess. Your child's gallbladder may leak bile and gallstones before it is removed, or bile could leak into his abdomen after surgery.
  
  
• Your child may still have gallstones after surgery, and he may need a different procedure to remove them. During the operation, the laparoscopic surgery may need to be converted to open surgery. This means that a larger incision will be made in your child's abdomen.

Getting Ready

The week before your child's surgery:

• Write down the date, time, and location of your child's surgery.
  
  
• When you take your child to see his caregiver, bring a list of his medicines or the medicine bottles. Tell caregivers if your child uses herbs, food supplements, or over-the-counter medicine. If your child is allergic to any medicine, tell his caregiver. Ask if you need to stop giving any of your child's medicines before the surgery.
  
  
• Your child may need blood or urine tests. He may also need imaging tests, such as x-rays, an ultrasound, or a CT scan. Ask your child's caregiver for more information about these and other tests. Write down the date, time, and location of each test.

The night before your child's surgery:

• Do not let your child eat or drink anything after midnight the night before surgery, or as directed.
  
  

The day of your child's surgery:

• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery on your child. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• Ask your child's caregiver before you give your child any medicine on the day of his surgery. Bring your child's pill bottles or a list of his medicines to the hospital or surgery center.
  
  
• Caregivers may insert an intravenous tube (IV) into your child's vein. A vein in the arm is usually chosen. The IV is used to give your child liquids or medicines.
  
  
• Your child may be given antibiotics before surgery to help prevent infection.
  
  
• Your child will be given medicine called anesthesia to keep him asleep and free from pain during surgery. Tell the caregiver if your child or anyone in your family has had a problem using anesthesia in the past.

Treatment

What will happen:

The surgeon will make between 1 and 4 small incisions on your child's abdomen or navel. He will insert the surgical tools and laparoscope into the incisions. The camera attached to the laparoscope will display images of your child's abdominal organs on a nearby monitor. The surgeon will fill your child's abdomen with carbon dioxide gas to make it swell. This allows him to see the organs better. It also gives him more room to move the surgical tools and laparoscope around. Your child's surgeon will search for and remove gallstones in and around his gallbladder. He will carefully separate your child's gallbladder and remove it through an incision, usually the navel incision. The carbon dioxide will be released from his abdomen. Your child's surgeon may inject medicine into his abdomen or incisions to reduce his pain after surgery. The incisions will be stitched or closed with adhesive strips, then covered with bandages.

After your child's surgery:

Your child will be taken to a recovery room until he is fully awake. Caregivers will watch him for any problems. Do not let your child get out of bed until his caregiver says it is okay. Your child will probably stay in the hospital for 1 night or more.

Contact a caregiver if

• Your child has a fever.
  
  
• Your child cannot make it to his surgery on time.
  
  
• You have questions or concerns about your child's surgery, medicine, or care.

Seek Care Immediately if

• Your child has severe abdominal pain.
  
  
• Your child cannot stop vomiting, or his vomit has blood or bile (yellowish-brown or green fluid) in it.