What Is a Cholecystectomy?
A cholecystectomy is surgery to take out your gallbladder. This small, pear-shaped organ in the upper right part of your belly stores bile, a fluid your liver makes to digest fat.
After you eat, your gallbladder releases bile through the common bile duct and into your small intestine. But your gallbladder exit duct can get blocked, infected, or inflamed.
When this happens, your gallbladder may not work as well or may stop working. You'll start to feel symptoms after you eat, more so after eating greasy or spicy foods.
Common symptoms of gallbladder problems
- Bloating and gas.
- Indigestion or heartburn.
- Nausea and vomiting.
- Sharp pain in the upper right or upper middle of your stomach. You may also have pain in your back or under your right arm.
- Yellow skin (jaundice).
Gallstones are the most common issue that blocks your gallbladder and causes problems. These small hard deposits, or stones, form in the gallbladder.
Gallstones are also the most common reason for gallbladder removal. But your doctor may advise a cholecystectomy for other gallbladder problems.
Doctors often find gallstones when you have imaging tests for other health issues. In most cases, they don't cause any symptoms, and you may not need your gallbladder removed.
Gallbladder Surgery Benefits and Risks
Changing your diet by eating less fatty, greasy, or spicy foods may help improve your symptoms.
But gallstones don't go away on their own. They can also travel outside your gallbladder and get lodged in other bile ducts, causing problems.
You can live without your gallbladder. Bile can reach your small intestine in other ways.
Removing it is the best way to improve most gallbladder problems.
Complications from gallbladder surgery are rare.
The risks are the same as with any surgery, including:
- Bleeding or bruising at the incision site.
- Blood clots.
- Reaction to the anesthesia.
Gallbladder surgery risks include:
- Bile leaking into your abdomen.
- Damage to blood vessels that go to your liver.
- Injury to your common bile duct, small intestine, or colon.
- Swelling of your pancreas (pancreatitis).
Conditions We Treat with Cholecystectomies
At the Division of Trauma and General Surgery at UPMC, we can remove your gallbladder if:
- Your gallstones cause repeated attacks of pain (biliary colic) or pancreatitis.
- Your gallbladder suddenly becomes inflamed or infected (cholecystitis).
- Growths (polyps) form in your gallbladder and cause symptoms. Doctors often advise surgery for polyps larger than 1 cm.
- Your gallbladder wall has calcified (porcelain gallbladder).
- You have gallstones and an impaired immune system.
What to Expect Before, During, and After Gallbladder Surgery
Before your surgery, your doctor may run tests, such as:
- Blood tests.
- Chest x-ray or EKG.
- HIDA scan, which uses a radiotracer dye to see how well your gallbladder and liver work.
- X-rays, ultrasound, or CT scans of your gallbladder.
Your doctor will give you written details on how to prep for your gallbladder surgery. Read these carefully at least a week before your surgery.
They'll tell you:
- If you can take certain drugs the morning of your surgery. If you can, take them only with a sip of water. Let your doctor know about all medicines and supplements you take so they can tell you which ones to stop taking.
- When to arrive for your gallbladder surgery the next day.
- When to stop eating and drinking the day before your surgery.
- When to take a shower and if you need to use an antibiotic soap.
During gallbladder surgery
There are two ways to remove a gallbladder.
Your surgeon will advise the best way for you based on factors like your:
- Medical history.
- Other health issues or prior surgeries.
For either surgery, you'll receive general anesthesia so you'll be asleep and not feel any pain.
Because gallstones may travel outside your gallbladder, your surgery may include a cholangiogram.
For this test, your surgeon will inject a dye into your common bile duct before taking an x-ray. This helps find wayward gallstones and remove them with a special device.
In most cases, both surgeries take two hours or less. How long it takes depends on whether you have complications.
Laparoscopic gallbladder removal
The most common method for taking out gallbladders is laparoscopic surgery.
During the procedure, your surgeon will:
- Make three to four small cuts in your abdomen.
- Insert a thin lighted tube with a built-in camera into one of the cuts to see inside your body.
- Place special surgical tools inside the other cuts.
- Pump gas into your belly to expand the space so they can see better and have more room to work.
- Cut the bile ducts and blood vessels attached to your gallbladder.
- Take out your gallbladder and close the incisions.
Your surgeon may need to switch to open gallbladder removal if you have issues during laparoscopic surgery that make it unsafe to continue that way.
Open gallbladder removal
If it's unsafe for you to have laparoscopic gallbladder removal, you'll need to have open gallbladder surgery.
During open gallbladder removal, your surgeon will:
- Make a large cut in your upper right torso, just below your ribs.
- Cut the bile ducts and blood vessels connected to your gallbladder.
- Take out your gallbladder and stitch you up.
After gallbladder surgery
Most people have less pain after laparoscopic gallbladder surgery compared to the open method. You can go home when you're able to drink liquids. That may be the same day. You may have to stay overnight if your pain isn’t well controlled, you can’t keep liquids down, or there were problems during surgery.
After open gallbladder surgery, you may need to stay in the hospital for a few days.
Before you go home, your UPMC gallbladder surgery team will give you written guidelines on:
- How to care for your incision and yourself post-op.
- When you can remove your bandages, take a shower, and go back to work.
- How long you should wait before you resume your normal activity.
You'll need to follow up with your surgeon in two to three weeks so they can see how you're healing and feeling.
Healing after gallbladder removal surgery
Your recovery time will depend on the type of surgery you had and any issues during surgery.
In most cases:
- Laparoscopic gallbladder removal takes a week to 10 days to heal.
- Open gallbladder removal takes four to six weeks to recover.
It's normal to feel some pain and soreness at your incision site or in your upper abdomen. You may also have shoulder pain from the gas used during surgery. This should go away within 48 hours.
For most post-op pain, acetaminophen (Tylenol) or ibuprofen (Advil) can help you feel better. Your doctor may also prescribe narcotic pain medicine.
Your surgeon may ask you not to lift anything heavy for a period of time after surgery to prevent hernias or bulges at the incision sites
When to call your doctor after gallbladder surgery?
Call your doctor if you don't start feeling better as each day goes by, or if you have any of these symptoms:
- Blood or pus coming from your incision site.
- Breathing problems or a cough that doesn't go away.
- Fever over 101 degrees F (38.5 C).
- Nausea or vomiting.
- Pain that medicine doesn't ease.
- Redness at your surgery site that spreads or gets worse.
- Severe pain or swelling in your belly.
- Yellow skin.
- You can't eat or drink anything.
Contact UPMC About Gallbladder Surgery
To make an appointment, contact a location near you. Or call 1-866-629-8077 if you need help.
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