(Gallbladder Removal; Lap Chole)
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 Cholecystectomy vs. Open Cholecystectomy
Reasons for Procedure
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.
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
- 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
Prior to Procedure
Your doctor will probably do some or all of the following:
- Blood tests to evaluate liver function
- Ultrasound to view gallstones
- Hepatobiliary iminodiacetic acid (HIDA) scan—an x-ray test that uses a chemical injected into the gall bladder to create pictures of your liver, gallbladder, ducts, and small intestines
- Electrocardiogram (EKG) and chest x-ray —to make sure that the heart and lungs are healthy enough for surgery
- MRI or CT scan to better view the gallbladder
Leading up to your procedure:
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one 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 and/or an enema to clean out your intestines.
- If instructed, shower before the procedure. You may be given special soap to use.
General anesthesia will be used. You will be asleep for the procedure.
Description of Procedure
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. Dye 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 one week.
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
If you do not have any problems, you may be able to go home the same day as the surgery or the next day.
At the Hospital
After the procedure, the hospital staff will:
- Monitor you for any problems
- Give you medications for 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.
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
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
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- 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 have been given
- Blood in the stool
- Persistent nausea and/or vomiting
- Bloating and gas that persist for more than a month
- Pain and/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 medical help right away.
Gastro—American Gastroenterological Association
National Digestive Diseases Information Clearinghouse
The Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Cholecystectomy. American College of Surgeons website. Available at: https://www.facs.org/~/media/files/education/patient%20ed/cholesys.ashx. Accessed May 28, 2013.
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;93:1185-91.
Gallbladder surgery: Laparoscopic cholecystectomy. University of California at Davis website. Available at: http://www.ucdmc.ucdavis.edu/surgery/specialties/gastro/gall.html. Accessed May 28, 2013.
Laparoscopic gallbladder removal (cholecystectomy) from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons website. Available at: http://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-gallbladder-removal-cholecystectomy-from-sages. Accessed May 28, 2013.
Martin DJ, Wernon DR, et al. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev. Apr 2006;19(2):CD003327.
3/23/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Short V, Herbert G, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst Rev. 2015 Feb 20;2.
Last reviewed February 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.