Cholecystectomy is the surgical removal of the gallbladder. The gallbladder is the small, pear-shaped pouch in the upper-right part of your abdomen that stores the bile produced by the liver. Bile, the digestive fluid that helps to break down fatty food, is carried from the gallbladder to the intestine through a tube called the bile duct.
There are two ways of performing a cholecystectomy:
- Laparoscopic cholecystectomy
This is the most common way of having your gallbladder removed. This is a recent technique that was developed in the US in 1988 and is also known as keyhole surgery. Keyhole surgery means the surgeon can remove your gallbladder without having to make a large incision on your abdomen. It’s also often carried out as a day case, which means you won’t have a long stay in hospital and a long recovery period. - Open cholecystectomy
During this procedure the surgeon removes the gallbladder through a five- to eight-inch incision in your abdomen. This procedure has been performed for more than 100 years and is quite safe. However, because it’s open surgery, you need to be in hospital for four to five days and need several weeks of recuperation at home after the operation.
Why does my gallbladder need to be removed?
Gallstones are often discovered by accident when a patient is having an X-ray or ultrasound scan for another reason. In these cases, it’s usually best to leave the gallstones alone, unless they go on to produce symptoms. This wait-and-see approach is called expectant management or watchful waiting.
However, if your gallstones have been causing symptoms, you may have been advised to have a cholecystectomy (although less than 20% of the people who have gallstones have painful symptoms).
Symptoms can include:
- Biliary colic
If the gallstones have passed into one of the bile ducts leading from the gallbladder to the intestine, or a gallstone gets stuck in the narrow neck of the gallbladder, it can lead to biliary colic, which can be painful and feels similar to severe indigestion. - Cholecystitis
When the presence of gallstones has led to the gallbladder becoming inflamed, it can cause pain below the ribs on the right side. You may also be feeling pain in the back and the right shoulder. Other symptoms include fever, nausea and vomiting. - Obstructive jaundice
Sometimes a gallstone can block the bile duct and lead to obstructive jaundice. This causes yellowing of the skin and the whites of the eyes, a darkening of the urine and pale, clay-coloured stools. - Acute pancreatitis
This happens when a small gallstone passes through a bile duct and blocks a pancreatic duct or causes a reflux of fluids and bile into this duct. Acute pancreatitis is rare. It develops in about 5% of people who have gallstones, and is more common in patients with small, multiple stones.
How long will I have to wait for an operation?
There may be a wait of a few months for this operation, but this depends on your healthcare provider or hospital and the length of waiting lists. Ask your doctor about estimated waiting times when you discuss the operation.
Why would I be recommended to have open surgery instead of keyhole surgery?
An open cholecystectomy is something that your doctor will advise on. It involves the removal of the gallbladder under general anaesthetic through a larger cut in the abdomen. An open cholecystectomy is recommended over laparoscopic surgery if your gallbladder is severely inflamed. In this case it can be difficult or dangerous to remove it via laparoscopic cholecystectomy. In addition, if a stone has passed out of the gallbladder and into the bile duct, it can be more difficult to remove via keyhole surgery. If complications arise during a laparoscopic cholecystectomy, it becomes necessary to turn the operation into open surgery.
What happens during gallbladder removal surgery
Gallbladder removal surgery, or cholecystectomy, is performed in the following steps:
- Anesthesia: The patient is given general anesthesia to render them unconscious during the procedure.
- Incision: The surgeon makes several small incisions in the abdomen, usually using a laparoscopic technique. A camera and long surgical instruments are inserted through these incisions.
- Disconnection of the gallbladder: The gallbladder is disconnected from the liver and bile ducts.
- Removal of the gallbladder: The gallbladder is removed through one of the incisions or through a small cut made near the navel.
- Closure of incisions: The incisions are closed with sutures or surgical staples.
- Recovery: After the procedure, the patient is monitored in the recovery room until they awaken from the anesthesia. They will then be able to return home, usually the same day or the next day.
The entire procedure usually takes 1-2 hours, and most people experience only minor discomfort after the procedure. The surgeon will provide instructions on how to care for the incisions and manage any pain.
What to expect after gallbladder removal
After gallbladder removal surgery, or cholecystectomy, most people can expect the following:
- Pain and discomfort: There may be some pain and discomfort in the incision area, which can usually be managed with pain medication.
- Recovery time: Most people can return to their normal activities within a few days to a week, but more strenuous activities may need to be limited for several weeks.
- Changes in bowel habits: Since the gallbladder is no longer there to store and release bile, some people may experience changes in their bowel habits, such as diarrhea or more frequent bowel movements.
- Dietary changes: It may be necessary to make some dietary changes to help the body adjust to the loss of the gallbladder. This may include avoiding fatty or greasy foods.
- Follow-up visits: The patient will need to follow up with the surgeon to monitor their recovery and address any concerns.
It is important to follow the instructions of the surgeon and report any symptoms that are not normal, such as increased pain, fever, or signs of infection. In general, most people have a smooth recovery after gallbladder removal surgery and are able to return to their normal activities relatively quickly.
Gallbladder removal recovery
Recovery from gallbladder removal surgery, also known as cholecystectomy, typically involves the following steps:
- Pain management: Pain medication will be prescribed to manage any discomfort at the incision site. It’s important to take pain medication as directed to ensure a comfortable recovery.
- Rest: It’s important to rest and avoid strenuous activities for a few days to allow the body to heal. Gradually, you can return to normal activities as recommended by your doctor.
- Eating: You may experience some digestive discomfort after the surgery, so it’s important to start with a bland diet of easily digestible foods and gradually reintroduce solid foods as tolerated.
- Follow-up appointments: You will need to attend follow-up appointments with your doctor to monitor your progress and ensure that you are healing properly.
- Avoiding certain activities: You should avoid lifting heavy objects or engaging in strenuous physical activity for several weeks after the surgery.
It’s important to follow your doctor’s instructions for a safe and smooth recovery. Most people are able to return to normal activities within a few weeks of the procedure, but the exact timeline will depend on your individual situation and the type of procedure you underwent. If you have any concerns or questions about your recovery, be sure to discuss them with your doctor.
Complications of gallbladder removal
Gallbladder removal surgery, or cholecystectomy, is generally a safe and effective procedure. However, like all surgeries, it does carry some risk of complications, including:
- Infection: The incision site can become infected, leading to redness, swelling, and pain.
- Bleeding: There may be some bleeding from the incision site, which may require further treatment.
- Injury to surrounding organs: During the procedure, there is a risk of injuring the liver, bile ducts, or other organs in the abdomen.
- Adhesions: Scar tissue can form and cause adhesions, which can cause abdominal pain and discomfort.
- Bile leak: Bile can leak from the bile ducts, leading to infection and abdominal pain.
- Pain: Some people may experience persistent pain in the abdomen or incision area.
- Bowel problems: Some people may experience changes in their bowel habits, such as diarrhea or constipation, after the procedure.
It is important to discuss the potential risks and benefits of the procedure with the surgeon and to follow their instructions for a safe recovery. If any symptoms arise that are not normal, it is important to seek medical attention promptly.
FAQs
What are the problems or long-term effects of gallbladder removal?
Although gallbladder removal surgery is generally considered safe, some people may experience problems years after the procedure. Some of the most common issues include:
- Indigestion and bloating: Without the gallbladder to regulate the release of bile, some people may experience indigestion or bloating after eating, especially if they consume fatty or greasy foods.
- Diarrhea: Some people may experience changes in bowel habits, including diarrhea, after the procedure.
- Bile duct problems: In rare cases, people may experience blockages in the bile ducts, which can lead to abdominal pain, jaundice, and other symptoms.
- Hormonal imbalances: In women, gallbladder removal can disrupt the normal balance of hormones, leading to menstrual irregularities, hot flashes, and other symptoms.
- Weight gain: Without the gallbladder to regulate the release of bile, some people may gain weight after the procedure.
It is important to talk to your doctor if you are experiencing any symptoms that are not normal after your surgery, as they may be able to provide treatment or make recommendations to help manage the symptoms.
Recommended diet after gallbladder removal
After gallbladder removal surgery, it is important to follow a balanced diet that supports digestive health and helps the body adjust to the loss of the gallbladder. Some dietary recommendations include:
- Gradually introduce new foods: Start with small amounts of easily digestible foods and gradually introduce new foods over the course of several weeks.
- Avoid high-fat foods: High-fat foods can cause digestive problems, such as bloating, gas, and diarrhea, so it’s best to limit your intake of fatty or greasy foods.
- Increase fiber intake: Fiber can help regulate bowel movements and promote digestive health, so it is recommended to include plenty of fiber-rich foods in your diet, such as fruits, vegetables, whole grains, and legumes.
- Drink plenty of water: Staying hydrated is important for digestive health, so make sure to drink plenty of water throughout the day.
- Limit caffeine and alcohol: Caffeine and alcohol can disrupt the digestive system, so it is best to limit your intake of these substances.
- Small, frequent meals: Instead of eating large meals, it may be easier to eat smaller, more frequent meals throughout the day to help support digestive health.
It’s important to remember that everyone’s digestive system is different, and what works for one person may not work for another. It’s best to work with a doctor or a registered dietitian to create a personalized diet plan that meets your individual needs.
Foods to avoid after gallbladder removal
After gallbladder removal, it is important to limit or avoid certain foods that can cause digestive problems. Some of the most common foods to avoid or limit include:
- High-fat foods: Foods that are high in fat, such as fried foods, butter, and fatty meats, can be difficult for the body to digest and may cause bloating, gas, and diarrhea.
- Greasy foods: Foods that are high in grease, such as fast food and processed snacks, can also be difficult for the body to digest and should be limited or avoided.
- Spicy foods: Spicy foods can cause abdominal discomfort and may trigger symptoms such as heartburn, bloating, and gas.
- Dairy products: Some people may have trouble digesting dairy products, such as cheese and milk, after gallbladder removal.
- Foods high in sugar: Foods that are high in sugar, such as candy, baked goods, and sweetened drinks, can cause digestive problems and may lead to weight gain.
It’s best to listen to your body and avoid foods that trigger symptoms, such as bloating, gas, and diarrhea. It is also a good idea to work with a doctor or a registered dietitian to create a personalized dietary plan that meets your individual needs.