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Gallbladder removal - open

Open gallbladder removal is surgery to remove the gallbladder through a large cut in your abdomen.

In open gallbladder removal surgery, a surgeon makes a large surgical cut in your belly. Surgery is done while you are under general anesthesia so you will be asleep and pain-free.

To perform the surgery:

  • The surgeon makes 5- to 7-inch cut in the upper right part of your belly, just below your ribs.
  • The area is opened up so the surgeon can view the gallbladder and separate it from the other organs.
  • The surgeon will cut the bile duct and blood vessels that lead to the gallbladder.
  • The gallbladder is gently lifted out and removed from your body.

An x-ray called a cholangiogram may be done during your surgery. To do this test, dye is injected into your common bile duct and an x-ray picture is taken. The dye helps find stones that may be outside your gallbladder. It also helps identify the branches of the bile duct. If other stones are found, the surgeon may remove them with a special instrument.

Open gallbladder removal surgery takes about 1 hour.

Alternative Names

Cholecystectomy - open

Why the Procedure Is Performed

You may need gallbladder removal surgery if you have pain or other symptoms from gallstones. You may also need it if your gallbladder is not working normally.

You may have some or all of these symptoms:

The most common way to remove the gallbladder is by using a medical instrument called a laparoscope (laparoscopic cholecystectomy). Open gallbladder surgery is used in cases where laparoscopic surgery is not safely possible. The surgeon may switch to an open surgery if removing it through a laparascope is unsuccessful.

Other reasons for the need to remove the gallbladder by open surgery may be:

  • Unexpected bleeding during the operation
  • Obesity
  • Pancreatitis
  • Pregnancy (third trimester)
  • Severe liver problems
  • You have had many surgeries in this part of your belly in the past

Risks

Talk with your doctor about any of these risks.

The risks of any anesthesia are:

The risks of gallbladder surgery are:

  • Bleeding
  • Infection
  • Injury to the common bile duct
  • Injury to the small or large intestine
  • Pancreatitis (inflammation in the pancreas)

Before the Procedure

Your doctor may ask you to have these medical tests done before your surgery:

Always tell your doctor or nurse:

  • If you are or might be pregnant
  • What drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription

During the week before your surgery:

  • You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
  • Ask your doctor which drugs you should still take on the day of your surgery.
  • Your doctor or nurse will tell you when to arrive at the hospital.

On the day of the surgery:

  • Do not eat or drink anything after midnight the night before your surgery.
  • Take the drugs your doctor told you to take with a small sip of water.
  • Shower the night before or the morning of your surgery.

Prepare your home for any problems you might have in getting around after the surgery.

After the Procedure

People usually stay in the hospital for 1 to 4 days after open gallbladder removal. During that time:

  • You will be asked to breathe into a medical device called an incentive spirometer. This helps keep your lungs working well so that you do not get pneumonia.
  • The nurse will help you sit up in bed, hang your legs over the side, and then stand up and start to walk.
  • At first you will receive fluids into your vein through an intravenous tube (IV). Soon, though, the doctors and nurses will ask you to start drinking liquids and then eat other foods.
  • You will be able to begin showering again while you are still in the hospital.
  • You may be asked to wear pressure stockings on your legs to help prevent a blood clot from forming. These stockings help keep your blood circulating well.

If there were problems during your surgery, or if you have bleeding, a lot of pain, or a fever, you may need to stay in the hospital longer. Your doctor or nurses will tell you how to care for yourself when you leave the hospital.

Outlook (Prognosis)

Most patients recover quickly and have good results from this procedure.

References

Jackson PG, Evans SRT. Biliary system. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 55.

Gurusamy KS. Surgical treatment of gallstones. Gastroenterol Clin North Am. 2010;39:229-244.

Keus F, Gooszen HG, van Laarhoven CJ. Open, small-incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis. An overview of Cochraine Hepato-Biliary Group reviews. Cochrane Database Syst Rev. 2010:(1):CD008318. Review.

Siddiqui T. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. Am J Surg. 2008;195(1):40-47.

Updated: 8/15/2013

Joshua Kunin, MD, Consulting Colorectal Surgeon, Zichron Yaakov, Israel. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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