Cholecystectomy—Laparoscopic Surgery

(Gallbladder Removal; Lap Chole)

by Rosalyn Carson-DeWitt, MD

Click here to view an animated version of this procedure.

Definition    TOP

Cholecystectomy is the removal of the gallbladder. Laparoscopic is one method for this surgery. Special tools are passed through small cuts in the belly. The tools will be able to cut and remove the gallbladder. This option can decrease recovery time compared to an open surgery which needs a large cut into the belly.

Laparoscopic vs. Open Cholecystectomy

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Reasons for Procedure    TOP

A diseased or damaged gallbladder may need to be removed. Gallstones are the most common cause. The stones can cause damage to gallbladder and liver if left untreated.

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review problems that can occur like:

  • 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:

What to Expect    TOP

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    TOP

Four small cuts will be made in your belly. Air will be pumped into the belly. It will increase space inside and make it easier to see the gallbladder.

A small scope will be passed through one of the openings. It will send images of the inside to a screen in the room. The doctor will use the images to guide the tools and remove the gallbladder. Other tools will be passed through the other cuts. They will be used to hold the gallbladder. They will clip off the main artery and tube that passes fluid to intestine. Once it is detached the gallbladder will be removed. The doctor may look for stones in the remaining tube that runs from the liver to the intestine. A special dye may be used to make the stones more visible. Any stones will be removed. The belly will be carefully checked. The cuts will be closed with stitches or staples. The area will be covered with bandages.

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    TOP

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?    TOP

About 30-60 minutes

How Much Will It Hurt?    TOP

Anesthesia will prevent pain during surgery. The cuts can be uncomfortable for a few days. The air used to pump up the stomach can also cause some discomfort. Medicine can help to manage the discomfort as well as rest.

Average Hospital Stay    TOP

You may be able to go home the same day or the next day. You may need to stay longer if there were problems.

Post-procedure Care    TOP

At the Hospital

After the procedure, the hospital staff will:

  • Monitor you for any problems.
  • Give medicine to control pain and nausea.
  • Give nutrition through an IV if needed.
  • Move you from a liquid diet to soft foods.

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

Full recovery takes about 3 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    TOP

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 persist 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 June 16, 2017. Accessed March 26, 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.
Laparoscopic gallbladder removal (cholecystectomy) from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons website. Available at: https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-gallbladder-removal-cholecystectomy-from-sages. Updated March 1, 2015. 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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