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Is An Elective Cholecystectomy Advisable For Advanced Gallbladder Disease?
Question: Hello. I am anxious about doing an elective gallbladder surgery and would like you to comment on the following probabibiliites. Do these figures for anesthesia and surgery seem accurate to you? THe odds of dying from gallbladder surgery seem frighteningly high, even at the low end of the range. Is making me think twice the risks of surgery vs, no surgery.
http://www.anesthesiaweb.org/risk.php
"Chance of dying as a result of general anesthesia alone = somewhat less than 11-16 deaths per 100,000 persons, depending upon general health of the persons (0.01-0.016%) (Lienhart 2006, Arbous 2001).
....
Chance of dying due to complications resulting from the operation of removing the gallbladder = 150 to 1400 deaths per 100,000 operations, depending upon health and technique of operation (0.15-1.4%) (Feldman 1994, Hannan 1999)."
http://www.anesthesiaweb.org/risk.php
"Chance of dying as a result of general anesthesia alone = somewhat less than 11-16 deaths per 100,000 persons, depending upon general health of the persons (0.01-0.016%) (Lienhart 2006, Arbous 2001).
....
Chance of dying due to complications resulting from the operation of removing the gallbladder = 150 to 1400 deaths per 100,000 operations, depending upon health and technique of operation (0.15-1.4%) (Feldman 1994, Hannan 1999)."
Brief Answer:
Comparing the other option, surgery has less risks.
Detailed Answer:
Hello,
Thank you for using HCM to post your health query.
I read carefully your question and I understand your concern.
Gallbladder its a very delicate organ. When people have pain on it, surgery its the best option of treatment. That is because the more time will pass, the more the patient will have complications from it if they postpone the surgery and older the patient would be (which means that more difficult will be with the age to handle well a surgery).
So as a conclusion, even if the statistics talk if rather high risks of surgery, in fact comparing it with the other option of waiting and treating it without surgery has much higher risks.
On the other side, if you have no complication so fat from the gallbladder, you can choose the Laparoscopic surgery which will keep you XXXXXXX one day on the hospital and will be much easier surgery. But your doctors know your health better so they would tell better which is the bet option for you.
I hope this is helpful and I have clarified you.
Let me know if you need more clarifications.
Otherwise please close and rate the answer.
Regards,
Dr. Papaqako
Comparing the other option, surgery has less risks.
Detailed Answer:
Hello,
Thank you for using HCM to post your health query.
I read carefully your question and I understand your concern.
Gallbladder its a very delicate organ. When people have pain on it, surgery its the best option of treatment. That is because the more time will pass, the more the patient will have complications from it if they postpone the surgery and older the patient would be (which means that more difficult will be with the age to handle well a surgery).
So as a conclusion, even if the statistics talk if rather high risks of surgery, in fact comparing it with the other option of waiting and treating it without surgery has much higher risks.
On the other side, if you have no complication so fat from the gallbladder, you can choose the Laparoscopic surgery which will keep you XXXXXXX one day on the hospital and will be much easier surgery. But your doctors know your health better so they would tell better which is the bet option for you.
I hope this is helpful and I have clarified you.
Let me know if you need more clarifications.
Otherwise please close and rate the answer.
Regards,
Dr. Papaqako
Above answer was peer-reviewed by :
Dr. Raju A.T
The surgery would be laparoscopic.
I understand your point about benefit vs. risk of surgery, nut cons you tell me if these numbers seem right to you or do they exaggerate the risk of surgery?
"Chance of dying due to complications resulting from the operation of removing the gallbladder = 150 to 1400 deaths per 100,000 operations, depending upon health and technique of operation (0.15-1.4%) (Feldman 1994, Hannan 1999)."
And would you say there is greater risk from anestheisa or the laparoscopic surgery itself?
I understand your point about benefit vs. risk of surgery, nut cons you tell me if these numbers seem right to you or do they exaggerate the risk of surgery?
"Chance of dying due to complications resulting from the operation of removing the gallbladder = 150 to 1400 deaths per 100,000 operations, depending upon health and technique of operation (0.15-1.4%) (Feldman 1994, Hannan 1999)."
And would you say there is greater risk from anestheisa or the laparoscopic surgery itself?
Brief Answer:
Some evidence based statistics
Detailed Answer:
Hello dear,
Thank you for the follow up question.
I checked these statistics in a evidence based website and here is what I found.
-- There is no significant differences in overall mortality or incidence of complications between the 3 types of procedures- Open Cholecystectomy mortality 0.2%; Small-Incision Cholecystectomy mortality rates 0.1%; Laparoscopic Cholecystectomy mortality rates 0%-0.1%.
-- Small-incision and laparoscopic cholecystectomy had shorter length of convalescence compared to open procedure.
-- Spinal anesthesia is safe and effective for laparoscopic cholecystectomy in low-risk patients.
Cannot compare the risk from anesthesia with the risk from the procedure itself because they are different things. But the bigger, multispecialities containing the hospital, the better the doctor who does the laparoscopic examination and procedure, then the safer it is.
So, to summarize I would say to relax, because you are young, and if your doctors are suggesting laparoscopy, tells me that you have had no complications from the gallbladder so you have almost no risk of thinking about mortality. You will go there, stay 1-2 days in hospital and return home as if nothing happened with less pain.
Regards,
Dr. Papaqako
Some evidence based statistics
Detailed Answer:
Hello dear,
Thank you for the follow up question.
I checked these statistics in a evidence based website and here is what I found.
-- There is no significant differences in overall mortality or incidence of complications between the 3 types of procedures- Open Cholecystectomy mortality 0.2%; Small-Incision Cholecystectomy mortality rates 0.1%; Laparoscopic Cholecystectomy mortality rates 0%-0.1%.
-- Small-incision and laparoscopic cholecystectomy had shorter length of convalescence compared to open procedure.
-- Spinal anesthesia is safe and effective for laparoscopic cholecystectomy in low-risk patients.
Cannot compare the risk from anesthesia with the risk from the procedure itself because they are different things. But the bigger, multispecialities containing the hospital, the better the doctor who does the laparoscopic examination and procedure, then the safer it is.
So, to summarize I would say to relax, because you are young, and if your doctors are suggesting laparoscopy, tells me that you have had no complications from the gallbladder so you have almost no risk of thinking about mortality. You will go there, stay 1-2 days in hospital and return home as if nothing happened with less pain.
Regards,
Dr. Papaqako
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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