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What is a cholecystectomy?
A cholecystectomy is surgery to remove your gallbladder.
Your gallbladder is a small organ that sits just below your liver on the right side of your abdomen (tummy). It collects and stores bile, which is used to help digest food.
Gallbladder removal can be done in 2 ways.
- Laparoscopic cholecystectomy — keyhole surgery.
- Open cholecystectomy — open surgery to remove your gallbladder.
When is a cholecystectomy needed?
Gallstones can form in your gallbladder. Your doctor may recommend having your gallbladder removed if you have gallstones that are causing problems.
Most people don’t have any symptoms with gallstones. But sometimes, gallstones can move into your bile ducts. These are pipes that carry bile from your liver to your gallbladder, and from your gallbladder to your small intestine. When this happens, gallstones can cause symptoms such as:
- abdominal (tummy) pain
- pain in your back or your right shoulder
- nausea and vomiting
Other complications of gallstones include:
- cholecystitis (inflammation of the gallbladder)
- pancreatitis (inflammation of the pancreas)
- jaundice
- infection of the bile ducts
A cholecystectomy and exploration of the bile duct is a procedure to remove your gallbladder as well as any stones found in your common bile duct.
Another reason for having a cholecystectomy is to treat gallbladder cancer. If you have gallbladder cancer, some additional surrounding tissue may also need to be removed.
How do I prepare for a cholecystectomy?
If you are having a cholecystectomy, you will be asked not to eat and drink for several hours before your surgery.
Your surgeon will discuss with you whether to stop taking any medicines or supplements. Make sure you follow all the instructions from your doctor.
What happens during the procedure?
A cholecystectomy is usually done under general anaesthetic.
Most people who have their gallbladder removed have a laparoscopic cholecystectomy (keyhole surgery). Some people need to have an open cholecystectomy, which requires a larger cut in your upper abdomen.
Laparoscopic cholecystectomy
For keyhole surgery to remove your gallbladder, your surgeon will make up to 4 small incisions (cuts) in your abdomen.
They will insert a laparoscope (instrument with a light and camera) into one of the incisions to see inside your abdomen. Surgical equipment to remove your gallbladder is inserted through the other cuts.
A small amount of carbon dioxide gas is pumped into your abdomen through one of the cuts. The gas lifts the wall of your abdomen away from your organs. It helps your surgeon to see what they are doing.
After your gallbladder has been removed, the carbon dioxide is allowed to escape. Then the incisions are stitched or closed with staples.
Recovering from a cholecystectomy
After having your gallbladder removed, you will be monitored in recovery. You may have some side effects from the general anaesthetic such as nausea or vomiting, which can be controlled with medicine.
You will have some pain in your abdomen after the operation, which can be controlled using pain-relief medicines. You may also have some pain in your shoulder from the gas used in the operation, which can be eased with:
- pain-relief medicines
- heat packs
- moving and walking around
You will have a drip in your arm at first, which will be removed after the anaesthetic wears off. You can take sips of water then slowly get back to eating and drinking normally.
You’ll need to stay in hospital for 1 to 2 days after a laparoscopic cholecystectomy. A longer hospital stay is needed after an open procedure.
Recovery at home will depend on the procedure you had. After a laparoscopic cholecystectomy, you can expect to return to your normal activities within 2 weeks.
You may feel tired for several weeks after your surgery. Avoid excessive activity and heavy lifting while you are recovering.
Your wounds will have clips or stitches. Make sure you keep your wounds clean.
Possible risks or complications of a cholecystectomy
A cholecystectomy is generally a safe procedure. But as with all surgery, there is a small risk of complications.
General complications of surgery can include:
- a reaction to the anaesthetic
- bleeding
- infection
- blood clots
Possible complications of gallbladder surgery include:
- injury of nearby organs
- leaking bile into your abdomen
- pancreatitis
- pneumonia
Contact your doctor immediately if you have:
- discharge from your wound(s)
- fever
- pain that is not controlled by pain-relief medicines
- yellow eyes or skin
- nausea and vomiting that is not improving
Other treatments for gallstones
Gallbladder removal is the usual treatment for gallstones. It is recommended as the best treatment for most people with painful gallstones.
There are medicines that can dissolve gallstones. Medicines have been tried on their own and with a treatment called lithotripsy to shatter the gallstones. However, these treatments are rarely recommended because:
- they do not always work
- they can cause side effects
- new gallstones often form after stopping treatment.
