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.

Complications from this surgery are uncommon. They include bleeding, infection and injury to the duct (tube) that carries bile to the intestines. The intestines or major blood vessels may also be injured when the instruments are inserted into the abdomen for a laparoscopic cholecystectomy.

Gallbladder surgery is the second most common type of surgery after a Caesarean section.

March 10, 2004 -- Mr. Ashcroft had surgery yesterday to remove his gallbladder. The cholecystectomy was done at George Washington University Hospital in Washington, D.C. by Dr. Bruce Abell. "Everything went as planned. He did very well," said Dr. Abell.

Mr. Ashcroft was listed in guarded condition, as is the usual practice in such circumstances. Because of his having had pancreatitis, Mr. Ashcroft is expected to stay in the hospital for observation for another 4 or 5 days.

The surgery to remove Mr. Ashcroft's gallbladder was done laparoscopically. He will not have a big scar to show reporters.

March 14, 2004 -- Mr. Ashcraft went home from the hospital today. He was in the hospital 10 days -- March 4-14.

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