Gallbladder removal

Gallbladder removal is an operation to take out your gallbladder. It can be done using keyhole surgery or open surgery. You might need to have your gallbladder removed if you have gallstones that are causing symptoms or have a disease affecting it.

The operation to remove a gallbladder is called a cholecystectomy. If it’s taken out using keyhole surgery the operation is called a laparoscopic cholecystectomy. If you have surgery where a bigger cut is made and your abdomen (tummy) is opened, it’s called an open cholecystectomy. 

About gallbladder removal

Your gallbladder is a small pear-shaped pouch that collects and stores a liquid called bile. Bile is important for digestion and it works in your bowel to help break down fats in food and help your body use some vitamins. 

The chemicals in bile can sometimes form lumps of solid material, called gallstones. The stones vary in size depending on the substance they’re made of. They can sometimes look like gravel and be as small as grains of sand or as large as a pebble.

Quite a lot of people with gallstones don’t know they have them, because they don’t have any symptoms. But sometimes gallstones, even very small ones, can irritate your gallbladder or get stuck in the tube that leads from your gallbladder.

If that happens, it can be very painful and lead to complications such as pancreatitis. If you have pain and inflammation, or complications, then your surgeon is likely to suggest you have your gallbladder removed.

You may need to have your gallbladder removed for other reasons; for instance, if you have polyps or gallbladder cancer.

Preparing for gall bladder removal

You’ll meet the surgeon carrying out your procedure to discuss your care. It may be different from what’s described here because it’ll be designed to meet your individual needs.

Your surgeon will explain how you can prepare for your operation. If you smoke, you’ll be asked to stop. Smoking increases your chances of getting an infection after surgery, which can slow down your recovery.

If your gallbladder is removed using keyhole surgery, it’s usually done in one day. But you may still need to stay in hospital overnight. If you have open surgery, you’ll need to stay in hospital for longer,

You’ll have gallbladder surgery under general anaesthesia. This means you’ll be asleep during the operation. Anaesthetics can make you sick, so it’s important that you don’t eat or drink anything for six hours before your operation. You can usually drink water up to two hours before but check with your anaesthetist or surgeon’s and always follow their advice.

Your surgeon will discuss with you what will happen before, during and after your surgery. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you feel fully informed so you feel happy to give your consent for the operation to go ahead. You will be asked to do this by signing a consent form.

You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may also need to have an injection of an anti-clotting medicine as well as or instead of wearing compression stockings.

What happens during gallbladder removal?

If you’re having keyhole surgery, your surgeon will make small cuts in your abdomen. They’ll then gently inflate your abdomen using carbon dioxide gas to create space and make it easier to see. Your surgeon will pass a long, thin telescope with a light and camera lens at the tip, called a laparoscope, through one of the cuts. They’ll be able to see the inside of your abdomen on a monitor. Your surgeon will put special instruments in through the cuts to take out your gallbladder.

When your gallbladder has been removed, the carbon dioxide gas is allowed to escape so your abdomen goes back down to normal. Your surgeon will remove the laparoscope and other instruments. They’ll close the wounds and may cover them with a dressing.

If you have open surgery, one larger cut is made in your abdomen to remove your gallbladder. Occasionally, your surgeon may need to switch from a keyhole procedure to open surgery during the operation. Your surgeon will explain this to you before your procedure, when asking you to give your consent.

The time the surgery takes can vary. Planned keyhole surgery to remove your gallbladder may take around one hour, depending on how inflamed or difficult the gallbladder is to remove. An emergency operation may take twice as long as a planned one.

What to expect after gallbladder removal?

Pain and discomfort

After having your gallbladder removed, you’ll need to rest until the effects of the anaesthetic have worn off. You’re likely to have some pain and discomfort after the operation once the anaesthetic wears off. You’ll be offered pain relief if you need it.

If you have keyhole surgery, you may notice some discomfort caused by the carbon dioxide gas that was put into your abdomen during the operation. This can also cause pain in your shoulder, but it usually gets better within a few days.

Stitches

If you have small cuts, your surgeon may use stitches that dissolve on their own or glue to close your wounds. If your wounds are closed with non-dissolving stitches, these will need to be taken out by the nurse after about seven to 10 days. You’ll need to make an appointment with your doctor or hospital for this. Before you go home, ask which type of stitches you’ve had, and when they’ll need to be removed.

If you have a large wound, you’re likely to have a dressing over it. Smaller cuts may be left without a dressing on them. You don’t need to worry about keeping these undressed wounds dry. Sometimes, small dressings (which may be waterproof) are put on keyhole surgery wounds. Your nurse should give you advice about how to care for your wounds.

Going home

If you’ve had keyhole surgery as a day procedure, you’ll usually spend a few hours recovering and can then go home as soon as you feel ready. You’ll need to arrange for someone to drive you home. Try to have a friend or relative with you for the first 24 hours after your surgery.

You may be given a date for a follow-up appointment, usually around two weeks after your operation.

You may feel a little tired or emotional after your operation. This is completely normal for many people. Having a general anaesthetic affects everyone differently. You may find that you’re not so coordinated or that it’s difficult to think clearly. This should pass within 24 hours. In the meantime, don’t drive, drink alcohol, operate machinery or sign anything important. Always follow your surgeon’s advice.

Recovering from gallbladder removal

Recovery from keyhole surgery is different for everyone. Some people feel back to normal within a week or so, but others take longer to make a full recovery. Talk to your surgeon about when you’re likely to get back to your normal routine. Don’t do too much at once. It’s important to build up gradually and stick to a routine if you can. Eating healthily, resting when you need to and not smoking will all help you recover well.

If you have an open operation with a large cut to your abdomen, your recovery will take longer. It may take up to eight weeks for you to make a full recovery.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen.

If you’re taking painkillers after your surgery, some of these may make you constipated. Eat plenty of fibre-rich foods such as fresh fruit and vegetables to keep your bowels moving regularly.

After surgery, you don’t need to avoid foods that triggered your gallstone symptoms. If you still notice any symptoms when you eat these foods, contact your doctor because you may have another condition that’s causing the symptoms.

You may feel sore for a few days after your surgery and may not feel like driving for a week or two. You shouldn’t drive if you’re taking any painkillers that make you sleepy. This doesn’t include over-the-counter painkillers, like paracetamol and ibuprofen. You also need to be comfortable when you’re driving and be able to perform an emergency stop. When you go back to driving, build up slowly and stop driving for a few days if you notice any pain or soreness.

You’ll probably be able to go back to work between 10 and 14 days after keyhole surgery, but it will depend on how well you recover and the type of job you do. If you do a lot of heavy lifting, walking or standing in your job it’s likely to take you longer to get back to work fully. After open surgery it will take longer to return to work. Ask your surgeon for advice.

Side-effects of gallbladder removal

Side-effects are the unwanted but mostly temporary effects that you may get after having surgery. Gallbladder surgery can cause some side-effects. These include:

• pain in your abdomen and in your shoulder
• bloating and discomfort in your tummy
• diarrhoea (or constipation, for some people)
• farting (passing wind)
• tiredness

If you have any of these symptoms after surgery and they haven’t disappeared by your follow-up appointment, it’s important to tell your surgeon. If these symptoms are particularly troublesome, speak to your doctor or contact your surgeon before your follow-up appointment.

Complications of gallbladder removal

Complications are when problems occur during or after an operation. Most people don’t have any complications from gallbladder surgery. Possible complications of any type of surgery include excessive bleeding, an infection, problems related to the anaesthetic or a blood clot, usually in a vein in your leg (deep vein thrombosis, DVT).

Possible complications specific to gallbladder surgery include the following.

• Injury to your bile duct. If one of your bile ducts is damaged it can cause a blockage or leak in the days after surgery, or even months later. Contact the hospital or your doctor if you have a high temperature, are in pain, feel sick or have jaundice (yellowing skin and eyes). There are various ways to repair an injury to your bile duct.
• Injury to other organs, including your bowel.
• Postcholecystectomy syndrome which includes sometimes vague digestive symptoms such as long-term diarrhoea, indigestion, feeling sick and bloating.

If you feel very unwell after your operation, it’s really important that you get medical help and follow your surgeon’s advice.