Cholecystectomy (gallbladder removal) is one of the most common operative procedures performed.
What does the gallbladder do?
Your gallbladder stores bile and enzymes from the liver. When you eat, your gallbladder squeezes to drain bile into the intestines to help you digest food.
What are the reasons for cholecystectomy?
Symptomatic cholelithiasis. If gallstones are present, they can lead to increased pressure and pain when the gallbladder contracts. Typically occurs with a fatty meal. Pain can last minutes to hours.
Acute cholecystitis. When the gallbladder drainage is blocked by gallstones, it can become acutely inflamed. Symptoms are similar to symptomatic cholelithiasis, but the symptoms don't resolve.
Source: UpToDate Images: Anatomy of the Gallbladder
What does surgery entail? What are the risks of the procedure?
Your gallbladder is under your liver. Laparoscopic surgery is typically done with an incision at your belly button and 3 incisions under your ribs on the right upper abdomen.
There is a risk of pain, bleeding, and infection with any surgical procedure. Specific to this procedure, there is a risk of damage to surrounding organs, including the liver and intestines.
The worst-case scenario is damage to the tube that drains from the liver into the small intestine, called the common bile duct. This complication is infrequent, but if it occurs, you will need more procedures and a longer hospital stay.
If we can't see things safely laparoscopically, we will proceed with an open incision under your ribs on the right. This is not common with elective surgery and is more likely in elderly diabetic patients with acute severe inflammation.
*IOC- there is an additional procedure that we will perform that shows us the bile ducts and allows us to see if there are any stones in the bile duct that can cause obstruction.
What can I expect post-operatively?
You will have several small incisions from the laparoscopic port sites. They will have absorbable sutures, nothing that needs to be removed. You will have glue or gauze and paper tape on the incisions. The glue will peel off on its own in 10-14 days. If you have gauze, you can remove this in two days and shower like normal. You will have paper tape strips on the incision, and these will peel off on their own.
You are at risk for a hernia through the small incisions, so avoid heavy lifting for 4 weeks after surgery.
You may take acetaminophen (Tylenol) and ibuprofen (Motrin) as needed for pain. These can be taken at the same time. Take the narcotic pain medication if your pain is severe despite the acetaminophen and ibuprofen. After the few first days, you should work on decreasing the number of narcotics that you are taking.
What can I eat after surgery?
There are no specific dietary restrictions. However, if you eat a fatty meal, it may cause loose stool (diarrhea) until your body adjusts to not having your gallbladder, which previously stored the chemicals used to digest fatty food. This is seen in about 10% of patients and usually resolves. If it lasts more than a few weeks, there are medication options to treat this.
What should I be worried about after surgery?
If you have fever >101 F, severe nausea/ vomiting, inability to tolerate liquids, severe abdominal pain, increasing redness, or drainage from your incisions.
UpToDate Patient Education
Patient Information from Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)
American College of Surgeons Operation Brochures