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 surgical removal of the gallbladder. This procedure is most often done laparoscopically. This is done through several small incisions in the abdomen. In some cases, the doctor may switch to open surgery. This involves a larger incision in the abdomen.

Laparoscopic vs. Open Cholecystectomy

Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure    TOP

This surgery is used to remove a diseased or damaged gallbladder. The damage is typically caused by infection or inflammation. This is often due to gallstones, which are crystals of bile that can form in the gallbladder. Sometimes, these get stuck in the ducts that bile normally flows through. This blockage in the ducts can damage the gallbladder and the liver.

Possible Complications    TOP

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

  • Gallstones that have accidentally entered the abdominal cavity
  • Bleeding
  • Infection
  • Injury to other nearby structures or organs
  • Reactions to general anesthesia
  • Blood clots

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect    TOP

Prior to Procedure

Your doctor will probably do some or all of the following:

Leading up to your procedure:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week 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 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 openings will be made in your abdomen. Carbon dioxide will be pumped into the abdomen to provide a better view.

The laparoscope will be inserted through one of the openings. It will provide images of the gallbladder and surrounding area. Instruments will be inserted through the other openings. They will be used to grasp the gallbladder and clip off the main artery and duct. The gallbladder will be removed through one of the openings. Contrast material may be injected into the duct to look for stones, which may be removed if found. The entire abdomen will be carefully examined. The incisions will be closed with sutures or staples. They will be covered with bandages.

A tiny, flexible tube may be placed into the area. This tube will exit from your abdomen into a little bulb. This is to drain fluid. The tube is usually removed within 1 week.

Immediately After Procedure    TOP

You will be taken to a recovery room.

How Long Will It Take?    TOP

About 30-60 minutes

How Much Will It Hurt?    TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay    TOP

If you do not have any problems, you may be able to go home the same day as the surgery or the next day.

Post-procedure Care    TOP

At the Hospital

After the procedure, the hospital staff will:

  • Monitor you for any problems
  • Give you medications to control pain and nausea
  • Provide you with nutrition through an IV if you have a tube in your stomach to drain fluid
  • Help you to slowly progress from a liquid diet to soft foods

Your bowels will work more slowly than usual. Chewing gum may help speed the process of your bowel function returning to normal.

Preventing Infection

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

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

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

  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision

At Home

Recovery takes about 3 weeks. You will have a special diet and physical activity plan to help with your recovery. Follow instructions on wound care to prevent infection. Your doctor may advise pain medications for discomfort. Your liver will take over the functions of the gallbladder. Some people notice that they have a little more trouble digesting fatty foods, particularly for the first month after surgery.

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: 3/23/2015

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