Your gallbladder is a small pouch connected to your liver and your intestines by tubes called bile ducts. It collects and stores a liquid called bile. Bile contains chemicals that help you to digest the fat in your food. Bile also helps your body to use some vitamins, such as vitamin A, D and E. Bile is released from your gallbladder and passes into your intestine when you eat.
Gallstones are lumps of solid material that develop from the chemicals in bile. The stones vary in size and can take years to develop. Sometimes they become large and can block your bile duct. Smaller ones may travel through the bile duct and block the opening from your pancreas. The pancreas is another organ that produces a fluid which empties into the bile duct. Blocking the opening from the pancreas can cause a serious condition called pancreatitis (inflammation of your pancreas).
You may need your gallbladder removed if you have gallstones and they are:
- causing pain and inflammation
- causing jaundice (your skin and the whites of your eyes become yellow)
- blocking the duct from your pancreas and causing pancreatitis
If you have gallbladder cancer, you may also need to have your gallbladder removed.
First, your surgeon will explain some of the things you will need to do. For example, if you smoke, you will be asked to stop. This is because smoking increases your risk of getting a chest and wound infection, which can slow your recovery.
Gallbladder removal using keyhole surgery is usually done as a day-case procedure, but you may need to stay overnight in hospital. The surgery is usually done under general anaesthesia. This means you will be asleep during the operation.
Anaesthetic can make you sick so it’s important that you don’t eat or drink anything for six hours before your operation. Follow your anaesthetist’s or surgeon’s advice.
Your nurse or surgeon will discuss with you what will happen before your surgery, including any pain you might have. If you’re unsure about anything at all, just ask. Understanding what’s going to happen can help you feel more at ease and comfortable. You may be asked to give your consent by signing a 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 anticlotting medicine such as heparin or fondaparinux. You may be given anticlotting medication as well as, or instead of wearing compression stockings.
There are some alternative treatments for gallstones.
- If you’re not currently having any symptoms, you may not need any treatment. Instead your GP will monitor your condition and may suggest treatment if you develop symptoms.
- If gallstones are in your bile duct, they may be removed during ERCP (endoscopic retrograde cholangio-pancreatography). This is a test that can be used to diagnose gallstones, and if they are found during the procedure they can sometimes be removed. This will depend on the size of your gallstones and where they are. ERCP gives a detailed X-ray of your pancreas and bile ducts using a special dye and a narrow, flexible tube-like telescopic camera called an endoscope. There’s more information about ERCP in our FAQs section.
If you have gallbladder cancer, you may have treatment using radiotherapy and/or chemotherapy instead of surgery.
Your surgeon will talk through with you any possible alternative treatments.
A gallbladder removal operation is usually done as keyhole surgery. Your surgeon will make small cuts in your abdomen (tummy). He or she will then gently inflate your abdomen using carbon dioxide gas to create space and to make it easier to see. Your surgeon will pass a laparoscope (a long, thin telescope with a light and camera lens at the tip) through one of the cuts. Your surgeon will be able to see your internal organs on a television screen.
At the end of the operation, the carbon dioxide gas is allowed to escape and the instruments are removed. Your surgeon will close the wounds with stitches or metal clips and cover them with a dressing.
Sometimes it isn’t possible to remove your gallbladder using keyhole surgery and your surgeon may need to do open surgery instead. This is where they make one larger cut in your abdomen to remove your gallbladder.
After having your gallbladder removed, you’ll need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
If you have keyhole surgery, you may have some discomfort and bloating caused by the carbon dioxide gas that was put into your abdomen (tummy) during the operation. This can also cause pain in your shoulder, but it usually eases within 48 hours after your operation.
If you have had your operation as a day-case, you will usually be able to go home when you feel ready. You will 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.
Before you go home, your nurse will give you some advice about caring for your healing wounds. You may also be given antibiotic tablets to take to prevent an infection. You may be given a date for a follow-up appointment.
Having a general anaesthetic can really take it out of you. You might find that you’re not as coordinated as usual 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.
If your wounds are closed with metal clips or stitches, these will be removed by a nurse after about a week. Dissolvable stitches are often used with this procedure. The time they take to disappear depends on what type you have. Ask before you go home what type of stitches you’ve had and when they are likely to be removed.
It usually takes two to three weeks to make a full recovery from keyhole surgery to remove your gallbladder. Talk to your surgeon about when you can get back to your normal routine. It varies from person to person, so it’s important to find out what this means for you.
If you have an open operation with a large cut to your abdomen (tummy), your recovery will take longer. It may take four to six 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. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
You may feel sore for a few days after your surgery and may not feel like driving for a week or two. The Royal College of Surgeons suggests you wait at least a week and build up gradually. If you have any pain or soreness, wait another day or two before you try driving again.
As with every procedure, there are some risks associated with gallbladder removal. We haven’t included the chance of these happening as they are specific to you will be different for every person. Ask your surgeon to explain how these risks apply to you.
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Possible side-effects include:
- shoulder pain
- abdominal (tummy) pain
- bloating and abdominal discomfort
- flatulence (wind passed from your back passage)
Complications are when problems occur during or after the procedure. The possible complications of any procedure include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot (deep vein thrombosis, DVT).
During the operation, your surgeon may need to change from a keyhole procedure to open surgery. This means they will need to make a bigger cut in your abdomen (tummy). This will only be done if it’s not possible to complete your operation safely using the keyhole technique. Other possible complications may include:
- accidental damage to your bile duct or other organs
- leakage of bile from your bile duct
If you do develop complications or feel very unwell after the operation, it’s really importantt that you get medical help and follow your surgeon’s advice. You may need medicines or further treatment.
How much time will I have to spend off work after having my gallbladder removed?
If you have your gallbladder removed using keyhole surgery, you will usually be able to go back to work within two to three weeks. The keyhole procedure is called laparoscopic cholecystectomy. If you have your gallbladder removed using open surgery, it may be four to six weeks before you can go back to work.
Most people can usually go home on the same day, or the day after keyhole surgery. It usually takes two to three weeks to fully recover but this varies from person to person, so it's important to follow your surgeon's advice. Recovery time is usually quicker if you have a keyhole procedure rather than an open one. But it’s important to remember that you’ve still undergone an operation and you may feel tired for a while.
If you have open surgery to remove your gallbladder, a larger cut in your abdomen (tummy) is made. This means your recovery will take longer than if you have keyhole surgery. You can usually get back to work within four to six weeks.
It's important to remember that everyone is different – some people may need to rest for longer, others may recover more quickly. The information here is a rough guide of what to expect. If you have a manual job where you’re doing heavy lifting, you may need to recover for longer before you can get back to work.
I recently had my gallbladder removed and have had diarrhoea ever since. Is this a result of my operation?
About one in 10 people get diarrhoea after having their gallbladder removed.
Doctors aren’t completely sure why you might develop diarrhoea after having your gallbladder removed. After your gallbladder is removed, bile will drain continuously into your bowel, rather than being stored and released only when you eat. This causes your liver to produce more bile salts and, if your bowel can’t absorb these, it will produce more water and salt than usual. This may cause diarrhoea. You may also develop diarrhoea because your stools tend to move through your bowel more quickly after gallbladder removal.
If you have diarrhoea for long periods of time, it can be very distressing. But, there are some things that you can do to help yourself.
- Eat high-fibre foods such as wholegrain breads, cereals, oats, lentils, fruit and vegetables. This will help to absorb excess water and bulk up your faeces, making them firmer.
- Try not to eat foods that make your diarrhoea worse, such as spicy and fatty foods and dairy products.
If your diarrhoea doesn’t get better, or if it’s severe, your GP may suggest medicines to ease your symptoms.
What is ERCP?
ERCP stands for endoscopic retrograde cholangio-pancreatography. It’s a procedure that can be used to diagnose and treat gallstones.
ERCP is a procedure that can be used to diagnose gallstones and sometimes remove them. The possibility of removal depends on where the gallstones are and how big they are (for example, if they are small and have left the gall bladder and are in your bile duct, they may be removable).
ERCP is done using a narrow, flexible, tube-like telescopic camera called an endoscope. The endoscope is passed through your mouth and down through your stomach to reach the place where the bile duct opens into your intestine. Dye is squirted down a tube inside the endoscope and an X-ray is taken. This helps to show any gallstones.
If your surgeon sees a gallstone during the procedure, they may be able to remove it using special instruments. He or she may widen the bile duct to allow the stone to pass through naturally. Your surgeon can also put very small drainage tubes in, called stents, which help the bile to flow around a gallstone.
You can have ERCP done as an outpatient. You will probably be awake during the procedure, though you may be given a sedative. This relieves anxiety and helps you to relax. When the procedure is finished, you may need to rest until the effects of the sedative have passed. You will be able to go home when you feel ready, but do make sure someone can take you home.
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