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Cholecystectomy is the surgical removal of the gallbladder organ. This organ lies near the liver. It stores bile that is made by the liver. Bile helps in the digestion of fatty foods. The gallbladder releases bile into a system of ducts that lead to the small intestine.
The open version of this surgery is done when the surgeon may not be able to perform a less invasive version called laparoscopic surgery]]> .
Laparoscopic Cholecystectomy vs. Open Cholecystectomy
Reasons for Procedure
This surgery is used to remove a diseased or damaged gallbladder. The damage is typically caused by infection or inflammation. The damage is often due to gallstones]]> , which are crystals of bile that can form in the gall bladder. Sometimes these get stuck in the ducts that bile normally flows through. This blockage in the ducts can damage the gallbladder and the liver.
Complications are rare, but no procedure is completely free of risk. If you are planning to have a cholecystectomy, your doctor will review a list of possible complications, which may include:
- Gallstones that have accidentally spilled into the abdominal cavity
- Injury to other nearby structures or organs
- Reactions to general anesthesia
- Blood clots
Some factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
Your doctor will probably do some or all of the following:
- Blood tests to evaluate liver function
- Ultrasound]]> to visualize gallstones
- HIDA scan (hepatobiliary iminodiacetic acid scan)—an x-ray test that uses a chemical injected into the gall bladder to create pictures of your liver, gallbladder, ducts, and small intestines
- Other radiological scans to better view the gallbladder
- ]]>EKG]]> and ]]>chest x-ray]]> to make sure that your heart and lungs are healthy enough to withstand the stresses of surgery
Leading up to your procedure:
- Talk to your doctor about your current medicines. Certain medicines may need to be stopped before the procedure, such as:
- Arrange for a ride to and from the procedure.
- Arrange for help at home after returning from the hospital.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- You may be given laxatives and/or an enema to clean out your intestines.
- You may be given antibiotics.
- You may be asked to shower the morning before surgery. You may be given a special anti-bacterial soap.
]]>General anesthesia]]> will be used. You will be asleep for the procedure.
Description of Procedure
The doctor will make an incision in the upper right area of your abdomen. The gallbladder will be separated from the surrounding structures, including the liver, bile ducts, and arteries.
Once the gallbladder is gone, your doctor may squirt dye into the remaining ducts. This will help show if there is a gallstone in the ducts. The duct may be opened to remove any stones. While your abdomen is open, your doctor will carefully examine the other organs and structures in the area. This will be done to make sure that you do not have any other problems. The incision will be closed with either sutures or staples. It will then be covered with a bandage.
Your doctor may place a tiny, flexible tube into the area where the gallbladder was removed. This tube will exit from your abdomen into a little bulb. This is to drain any fluids that may build during the first few days after surgery. The tube is usually removed within one week after your operation.
Immediately After Procedure
The gallbladder will be examined by a pathologist. You will be taken to a room to recover where you will be monitored closely.
How Long Will It Take?
About 30-60 minutes
How Much Will It Hurt?
You will most likely feel some pain after the surgery. Your doctor will arrange for pain medicines.
Average Hospital Stay
At the Hospital
- You will be monitored for any problems.
- You may need medicines for nausea.
- You may have a nasogastric tube, which is a tube that will go from your nose, down your throat, and into your stomach. The tube will help to drain fluids and stomach acid. You will not be able to eat or drink until this is removed and you are no longer nauseated. You will continue to receive fluids and sugar through an IV.
- Once you are able to take things by mouth, you will be started on a liquid diet. Your diet will be progressed through soft foods to a regular diet.
Recovery takes about 4-6 weeks.
When you return home, do the following to help ensure a smooth recovery:
- Be sure to follow your doctor’s instructions .
- You will get a diet and physical activity plan to help you through recovery. Following the plan will help your recovery.
- Your liver will take over the functions of the gallbladder. Some people notice that they have a little more trouble digesting fatty foods, particularly for the first month after surgery.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
- Cough, shortness of breath, chest pain
- Increased abdominal pain
- Pain that you cannot control with the medicines you' have been given
- Blood in the stool
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
- Bloating and gas that persist for more than a month
- Pain, burning, urgency or frequency of urination, or blood in the urine
- Pain and/or swelling in your feet, calves, or legs
- Dark urine, light stools, or evidence of jaundice]]> (yellowing of the skin or eyes)
American Gastroenterological Association
National Digestive Diseases Information Clearinghouse
The Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
About cholecystectomy: surgical removal of the gallbladder. American College of Surgeons. Medem website. Available at: http://www.medem.com/ . Accessed July 11, 2008.
Clayton ES, Connor S, Alexakis N, Leandros E. Meta-analysis of endoscopy and surgery versus surgery alone for common bile duct stones with the gallbladder in situ . Br J Surg . 2006;93:1185-91.
Gallbladder removal. Baylor College of Medicine Department of Surgery website. Available at: http://www.debakeydepartmentofsurgery.org/home/content.cfm?proc_name=cholecystectomy&content_id=272 . Accessed July 11, 2008.
Gallbladder surgery: laparoscopic cholecystectomy. University of California at Davis website. Available at: http://www.ucdmc.ucdavis.edu/surgery/specialties/gastro/gall.html . Accessed July 11, 2008.
Laparoscopic surgery: bile, duct, and gallbladder. New York University School of Medicine website. Available at: http://www.nyulaparoscopy.org/surgeries/gallbladder.html#stones . Accessed July 11, 2008.
Martin DJ, Wernon DR, Toouli J. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev . Apr 2006;19(2):CD003327.
Townsend CM, Beauchamp RD, Evers BM, et al. Sabiston Textbook of Surgery . 16th ed. Philadelphia, PA: WB Saunders; 2001;1076-1095.
What are the surgical procedures for gallstones and gallstone disease? University of California at Davis website. Available at: http://www.ucdmc.ucdavis.edu/ . Accessed August 16, 2003.
Last reviewed October 2009 by ]]>Igor Puzanov, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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