Gallbladder removal surgery

What is gallbladder removal surgery

Cholecystectomy (gallbladder removal surgery) is a surgical procedure used to remove the gallbladder, including gallstones. Gallstones form within the gallbladder out of excessively thick bile components and may cause abdominal pain, in which case especially small gallstones are dangerous. The subsequent gallbladder inflammation is accompanied by severe pain and fever. If the gallstones migrate out of the gallbladder further to bile ducts they may cause jaundice by obstructing the bile ducts and very serious pancreas inflammation. A gallbladder attack comes on rather suddenly, starting as an intense pain in the epigastrium that progresses to the back under the right shoulder blade. It usually starts 30 minutes to 3 hours after eating and is often accompanied by vomiting (sometimes bile vomiting).

Who should undergo the surgery

Gallbladder surgery is most commonly performed as a laparoscopic procedure and is basically meant for all patients with a gallbladder disorder - be it gallstones, acute or long-term gallbladder inflammation or other disease (e.g. polyps on the gallbladder wall).

Before the procedure

Should the gallbladder surgery be indicated, the surgeon will explain the procedure and anesthesia and inform you about any risks related to the surgery. You may ask any questions, in particular, questions related to the procedure, your expectations and concerns, during the discussion. At the same time, you will be provided with an information sheet on how to prepare for the surgery, including information on eating, drinking, smoking and taking or discontinuing some medicines, which will be explained to you. Complying with all the recommendations is necessary for the surgery to run smoothly and for event-free healing.

Nonsurgical treatment options may be selected in some cases:

• Gallstones can be dissolved by medicines; however, this treatment has only a temporary effect - the gallstones either do not dissolve completely or form again quickly after the drugs are discontinued;
• Ultrasound is used to break gallstones apart; this procedure also has a temporary effect, gallstones are quickly formed again and there is a risk of obstructing bile ducts with smaller fragments.

What´s the procedure for gallbladder removal

The procedure is done laparoscopically under general anesthesia. Several openings (ports) are used to insufflate carbon dioxide into the abdominal cavity which is followed by separating the gallbladder from the bile duct and the liver. A drain is introduced into the subhepatic region after the surgery. For complicated surgical sites, anatomic deviations or any other high-risk finding, the laparoscopic procedure may be changed into (classical) open surgery, the only difference being an incision made in the abdomen.

After the surgery

In the hours immediately after surgery, you may feel pain in the surgical site(s). This pain is completely natural and it will be reduced by means of pain-killers. After discharge, you will use drugs to treat pain that your treating physician will prescribe to you. You should be pain-free within 24-48 hours. Long-term pain is usually an indication of a complication and, therefore, you should contact your treating physician in this case. Sometimes, vomiting occurs which is an adverse effect of anesthesia, in particular general anesthesia, and it usually subsides within 6-12 hours after surgery. You may start walking within a few hours of surgery. It is recommended to avoid stress for 3 weeks after the laparoscopical procedure (including sports and more demanding leisure activities) and comply with a strict gallbladder diet (double that time for open surgeries). It is not recommended to bathe, either in a bathtub or in indoor and outdoor swimming pools until surgical wounds are healed. It is more appropriate to take a shower. The sick leave is 2-4 weeks in average depending on the profession.