Ashcroft Surgery for Gallstone Pancreatitis

Medical Authors and Editors: Barbara K. Hecht, Ph.D. and Frederick Hecht, M.D.

March 9, 2004 -- Attorney General John Ashcroft has, or had, the most publicized gallbladder since President Lyndon Baines Johnson. After LBJ had his gallbladder out, he showed the press his scar. Whether Mr. Ashcroft's scar will be on display soon is not known.

Mr. Ashcroft was hospitalized on March 4 with acute gallstone pancreatitis -- sudden inflammation of the pancreas due to a gallstone blocking the common duct through which the pancreas normally secretes digestive enzymes into the intestines.

Now his pancreatitis has cooled down enough so that surgery can be done. The surgery is to remove the gallstones and the gallbladder. Removal of the gallbladder is called cholecystectomy. When the gallbladder is not removed, there is recurrence of pancreatitis within 6 weeks in half of patients. Cholecystectomy is therefore routinely done after a bout of gallstone pancreatitis.

Cholecystectomy -- in LBJ's case and now

In LBJ's case, the gallbladder was removed through a 5 to 8 inch long incision, or cut, in the abdomen. The cut was made just below the ribs on the right side and went to just below his waist. This is called open cholecystectomy.

A newer way to remove the gallbladder is called laparoscopic cholecystectomy. This surgery uses a laparoscope to remove the gallbladder, an instrument in common use today to see and operate inside the body. The surgery is performed through several small incisions in the abdomen rather than through one large incision.