Monday, February 15, 2010

The Checkup - Gallbladder surgery deaths rare

U.S. Rep. John Murtha's death yesterday from complications following gallbladder surgery he had in January was a very rare occurrence. According to the American College of Surgeons, among generally healthy people undergoing such surgery, deaths occur in only 0 to 1 per 1,000 patients.

Murtha, 77, reportedly was readmitted to the hospital Jan. 31 after his earlier surgery; it turned out his large intestine had been damaged during the removal of his gallbladder. Murtha's surgery was said to be laparoscopic, a minimally invasive approach that's become the standard of care in most hospitals, rather than the more invasive "open" surgery.

Hartford, Conn. surgeon Peter Bloom, who removed my own stone-ridden gallbladder 13 years ago, says no randomized, clinical trial has ever pitted the two approaches against one another, so it's really not known whether one is safer than the other. Still, the risks each poses are pretty much the same.

First are the general risks associated with any surgery, Bloom explains. Problems such as stroke, heart attack, blot clots traveling to the lungs and causing a pulmonary embolism, infection and problems with anesthesia are common to both procedures. These complications "might do someone in in a day," Bloom says. A patient's age and overall health can affect the risk of complications from gallbladder removal or any other surgery, he adds.

Other complications specific to gallbladder surgery often take longer to make themselves apparent, Bloom says. These include injury to the bile duct, intestine or liver.

When I told Dr. Bloom that I don't remember hearing about any of those risks before my surgery, he laughed and said nobody ever remembers. But he says he sits down with every patient before scheduling surgery and goes over a booklet that includes the full list of potential complications. "It's frightening, and part of it is in unfamiliar language," Bloom says, noting that he doesn't recall being told the risks of surgery he himself has received, so eager was he just to get on with the procedure.

"Most people just want to get better," Bloom says. And, thankfully, most do.