Gallbladder surgery or cholecystectomy may be undertaken when a person has gallbladder disease or gallstones that are causing painful inflammation and discomfort. The surgery is a common one, and there are now two methods by which it can be performed. One is the open method, where a surgeon makes an incision in the abdomen to remove the gallbladder and the other is a laparoscopic method, where small cuts in the abdomen are used with a special lighted tube that can remove the gallbladder. Laparoscopic surgery may not be appropriate in all cases and 20% of people who initially go in for laparoscopy to remove the gallbladder end up having an open surgery.
People anticipating gallbladder surgery should expect that the surgeon will discuss options and determine which surgery method is best based on conditions. Having a conversation with a surgeon prior to the surgery is an important time for patients, who should be ready to ask a few questions and make a few comments. For instance, people need to fully inform doctors about any medications they take. Blood-thinners like aspirin and warfarin may need to be discontinued several days prior to the surgery to lower risk of internal bleeding. Other medications like birth control pills might be affected by anesthesia, and people should discuss this with their doctor.
The day of or the day before surgery, people may need to have blood tests to rule out presence of infection or other things that may complicate surgery. Some might also require x-rays, sonography or other tests before the surgery is performed. Patients having a gallbladder surgery are often told they should not eat the night before the surgery, and they should follow specific recommendations from the surgeon on whether food and/or water are acceptable, and when food or water needs to be discontinued.
Sometimes gallbladder surgery is performed in a hospital and other times it is undertaken at an outpatient surgical center. If it is an open procedure it’s likely to be the former, and any chance of complications suggests that performing the surgery at a hospital is preferable. It is possible to go home the day of a laparoscopic gallbladder surgery, but open procedures may require a few days stay in the hospital, usually between two to five days. Laparoscopy may also require at least an overnight stay.
The surgery, however performed, uses general anesthesia. In the case of laparoscopic cholecystectomy, one part of the method may be felt upon waking. The abdomen is inflated with a special gas that makes visualizing the organs clearer. This is usually not required in open procedures. This inflation may cause some discomfort in the stomach and shoulders for a couple of days after the surgery.
When people wake up from anesthesia, muscles may feel sore. The throat can be sore and the voice hoarse since a person usually has a tube down their throat during the surgery to prevent accidental aspiration (vomit getting into the lungs). Pain medication can be given to help reduce discomfort, but emphasis in the first few days is also on getting patients to start moving. Constipation is a pretty common symptom of pain meds, and it may be partly helped by walking around a bit. Other people have diarrhea, gas or nausea and vomiting after the surgery, which may resolve in a few hours.
Patients might also note some things attached to their body after the surgery. This could include a t-tube, which drains bile from the body. Many people have an IV (intravenous) line that provides them with fluids. Some people might have an oxygen mask, and all patients might wear a blood pressure cuff, which periodically takes blood pressure. As the patient fully recovers, many of these of these things are removed.
When patients go home, they should watch for any potential complications. These include an evidence of infection at the incision/s (redness, warmth, swelling, pus), and significant bleeding from the incisions site/s. If the skin becomes yellow or if urine is dark yellow or brown, this could indicate that the body is not handling bile appropriately. Any of these signs need to be brought to the attention of the surgeon immediately since this may indicate serious problems.
Recovery after a gallbladder surgery takes a few weeks. Most people are ready to resume their lives completely in about 10-14 days. They will probably need to return to their surgeon for stitches removal, and for a general check up. While many have an uncomplicated recovery, some people develop a condition called post-cholecystectomy syndrome, and may have diarrhea, gas, bloating and nausea, particularly after meals. This tends to be treated with drugs like cholestryamine.
