Cholecystectomy—Open Surgery

(Gallbladder Removal—Open Surgery)

by Rosalyn Carson-DeWitt, MD

Click here to view an animated version of this procedure.

Definition

Cholecystectomy is the removal of the gallbladder. Open is one method for this surgery. It uses a large cut into the belly.

Laparoscopic vs. Open Cholecystectomy

Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

A diseased or damaged gallbladder may need to be removed. There is another option that uses smaller cuts and may have a quicker recovery. The option called laparoscopic surgery is not always appropriate.

Open may be needed if there is:

  • Cirrhosis of the liver
  • Gallbladder tumor
  • Past history of surgery to the belly
  • Third term pregnancy

Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will review problems that may happen such as:

  • Gallstones that end up in the belly
  • Bleeding
  • Infection
  • Injury to other nearby structures or organs
  • Reactions to general anesthesia
  • Blood clots

Some factors that can increase your risk of problems include:

  • Increased age
  • Pregnancy
  • Obesity
  • Smoking
  • Malnutrition
  • Recent or chronic illness
  • Diabetes
  • Heart or lung problems
  • Bleeding disorders
  • Drinking
  • Use of certain medications

What to Expect

Prior to Procedure

Your doctor will use info from earlier tests. Helpful information may include:

Leading up to your procedure:

  • Talk to your doctor about any medicine you take. You may be asked to stop taking some medicine before the procedure.
  • Arrange for a ride to and from the procedure. Also, have someone help you at home.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.
  • You may be given laxatives or an enema. They will help to clean out your intestines.
  • If instructed, shower before the procedure. You may be given special soap to use.

Anesthesia

General anesthesia will be used. You will be asleep for the procedure.

Description of Procedure

An incision will be made in the upper right area of the belly. The gallbladder will be separated from the items around it. This includes the liver, bile tubes, and blood vessels.

The bile tubes will be checked for stones. A dye may be used to highlight any stones. The tube may be opened to remove any stones. The rest of the belly will be carefully checked. This will be done to make sure you do not have any other problems. The cut will be closed with stitches or staples. The area will then be covered with a bandage.

A tiny, flexible tube may be placed in one of the cuts. It will exit from your belly into a little bulb. It will help to drain fluid from the area to help recovery. The tube is usually removed within 1 week.

Immediately After Procedure

You will be taken to a recovery room. There you will be cared for while you wake up from anesthesia.

How Long Will It Take?

About 30-60 minutes

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. The cut can be uncomfortable for a few days. Medicine can help to manage the discomfort.

Average Hospital Stay

2-6 days

Post-procedure Care

At the Hospital

In the recovery room, the staff will monitor you for problems. In addition:

  • You may have a tube that will go from your nose down into your stomach. The tube will help to drain fluids and stomach acid. You will not be able to eat or drink until this is removed. You will continue to receive fluids and nutrition through an IV.
  • When you are able you will be started on a liquid diet. Your diet will be slowly moved from liquid to soft foods. Then to your regular diet.

At first, your intestines will work more slowly than usual. Chewing gum may help.

Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Wash their hands.
  • Wear gloves or masks.
  • Keep your incisions covered.

There are also steps you can take to reduce your chance of infection such as:

  • Wash your hands often. Remind your care team to do the same.
  • Remind your care team to wear gloves or masks.
  • Do not allow others to touch your cuts.

At Home

Recovery takes about 4-6 weeks. The gallbladder plays a role in breaking down fatty food. The liver will begin to take over the job but you may need to make some changes in the beginning. You will be given a food plan. It will include slowly getting back to your regular diet. Some can have discomfort after eating fatty foods. This is most true in the first month after surgery. Slowly add different foods to your diet. Focus on smaller meals. This may prevent major discomfort.

Call Your Doctor

Call your doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
  • Cough, shortness of breath, chest pain
  • Increased abdominal pain
  • Pain that you cannot control with the medications you were given
  • Blood in the stool
  • Persistent nausea or vomiting
  • Bloating and gas that last for more than a month
  • Pain or swelling in your feet, calves, or legs
  • Dark urine, light stools, or yellowing of the skin or eyes

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Gastroenterological Association
http://www.gastro.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org
Canadian Digestive Health Foundation
http://www.cdhf.ca

References:

Cholecystectomy. American College of Surgeons website. Available at: https://www.facs.org/~/media/files/education/patient%20ed/cholesys.ashx. Accessed March 26, 2018.
Cholecystectomy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T900759/Cholecystectomy . Updated August 17, 2018. Accessed September 3, 2018.
Clayton ES, Connor S, Alexakis N, Leandros E. Meta-analysis of endoscopy and surgery versus surgery alone for common bile duct stones with the gallbladder in situ. Br J Surg. 2006;93(10):1185-1191.
Dasari BV, Tan CJ, Gurusamy KS, et al. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev. 2013;12:CD003327.
Gallbladder surgery: Laparoscopic cholecystectomy. UC Davis Health website. Available at:
...(Click grey area to select URL)
Accessed March 26, 2018.
3/23/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : Short V, Herbert G, Perry R, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst Rev. 2015;2:CD006506.
Last reviewed March 2018 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 9/3/2018

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