The gallbladder is a small, pear-shaped organ in the abdomen. Its job is to store and release bile, a fluid made by the liver. Bile helps break down fats in the food you eat. Normally, bile moves smoothly through the digestive system. Stones formed in the gallbladder, however, can block the release of bile. This can cause pain and lead to serious complications.
Treatment: To remove gallstones and prevent new ones from forming, the gallbladder is removed. The operation is called a cholecystectomy.
Why not just remove the gallstones? Unless the gallbladder is removed, more stones are likely to form. The gallbladder may also need to be removed for reasons other than stones.
Your surgery: Your surgery will be done in a hospital or surgery center. Most gallbladder problems are treated using laparoscopy. But certain factors may mean that open surgery is a safer procedure for you. There is also a chance that your doctor may need to switch from laparoscopy to open surgery during the procedure.
Before Surgery: You will be given an IV to provide fluids and medications. An anesthesiologist will explain the medications used to prevent pain during surgery. Gallbladder surgery is done using general anesthesia so you sleep during the procedure.
Laparoscopy is the most common method for removing the gallbladder. Laparoscopy is done using a laparoscope, a long ting device that has a small light and camera. It sends images to a video monitor so your doctor can see inside your abdomen during surgery.
During surgery, small incisions are made in the abdomen. A harmless gas is then used to lift the abdominal wall away from the internal organs. The laparscope is inserted to view the inside of the abdomen. Surgical instruments are inserted to remove the gallbladder. Small clips close off the bile duct and blood vessels to prevent bleeding and bile leaks. The gallbladder is then detached from the liver. The clips are made of metal (titanium) or plastic that do not harm the body; and they are left in place. The gallbladder is then removed and carefully lifted out through the incision. Bile will now flow directly from the liver to the small intestine.
Open surgery is most often used when scarring from past surgeries or other factors make it a safer procedure. Your doctor may also decide during surgery to switch from a laparoscopic to an open procedure. This does NOT mean something has gone wrong. Instead it is done when your doctor feels it is safer to remove the gallbladder through a larger incision. If you have open surgery, the same methods are used to detach the gallbladder from the bile ducts. The main difference is you will have a larger incision in your abdomen. Having open surgery also means a longer recovery period after the procedure.
During opem surgery, an incision is made in the abdomen. This incision may be made in the upper right side or middle of the abdomen. The open incision gives your doctor a clear view of the gallbladder and bile ducts. Small clips or sutures close off the bile duct and blood vessels. These help prevent bleeding and bile leaks. The clips are made of metal (titanium) or plastic that does not harm the body. If clips are used, they will remain in place. The gallbladder is removed. Once the clips are secured, the gallbladder is detached from the liver. It is then carefully lifted out of the abdomen. Bile will now flow directly from the liver to the small intestine. The incision is closed with sutures or staples.
After surgery you will be taken to a recovery area. Bandages will cover your incisions and you may have special boots on your legs to prevent blood clots. If you had laparoscopy, you may also have some shoulder pain. This is caused by the gas used during surgery. To aid recovery, you will be asked to get up and move as soon as possible. You may also be asked to use a device that helps keep your lungs clear.
After laparoscopy, you can often go home the same day. For open surgery, you will need to stay in the hospital for a few days. Once you are home, follow your doctor’s instructions to manage pain and care for your incisions. As you feel better, you can start getting back to your normal routine. Keep in mind, though, that recovery will take longer if you had an open procedure.
Managing Pain: It is normal to have some pain during recovery. To help you feel better, your doctor will prescribe pain medications to use at home.
If You Had Open Surgery: Recovering from open surgery is more painful than the recovery for laparoscopy. This is because an incision was made in the abdominal muscles to remove the gallbladder. The muscles will heal. But for a time, it may hurt to bend, stand, or take deep breaths. To help manage pain, you may receive a special pump that lets you give yourself pain medication. Keep in mind, you still need to move around as often as you can. This helps prevent blood clots and can help you heal.
Recovery at Home: You will likely feel tired and may have some bruising around the incisions. You may also have some cramping after a few days. This is normal and goes away in time. To speed healing:
- Follow your doctor’s instructions about bathing and caring for your incisions.
- Talk with your doctor about what to eat. You may need to start with light meals.
- Walk and move around as often as possible. This improves blood flow and can help you feel better.
Easing Back into Activities: You can start getting back to your normal routine as soon as you feel able. Just take it easy at first and follow all your doctor’s advice. For best results:
- Ask your doctor about driving and going back to work. After laparoscopy, you can often return to work within 5 to 10 days. For open surgery, it may be up to 6 weeks.
- Use pain relievers with acetaminophen to relieve occasional discomfort.
- You can have sex again when you are ready.
Call your doctor if you notice any of the following during your recovery.
- Fever over 101F
- Sharp or increasing pain
- Increasing redness or drainage from an incision
- Vomiting or nausea that lasts for more than 12 hours
- Shortness of breath
- Pain or swelling in your calf
- Symptoms of jaundice
- Prolonged diarrhea