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Gallbladder removal


Expert reviewer, Dr Yiannis Kallis, Consultant Hepatologist and Gastroenterologist
Next review due September 2020

You may need to have your gallbladder removed if you have gallstones or if your gallbladder becomes diseased or damaged. Your gallbladder plays a very important role in your digestive health. It collects and stores a liquid called bile, which it releases after you’ve eaten to help your body digest food.

If you need to have your gallbladder removed, it will be done using one of two main types of surgery.

  • Laparoscopic cholecystectomy – your gallbladder is removed through small puncture holes in your tummy (abdomen). This is called keyhole surgery and is the most common method.
  • Open cholecystectomy – your gallbladder is removed through one large cut in your tummy. This is called open surgery. You may need this option if you have another condition or complications that could make surgery difficult.

  • An image showing a diagram of the upper digestive system

    Why would I need my gallbladder removed?

    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, which is made in your liver. Bile contains chemicals that help you digest the fat in your food, as well as waste products that can be excreted from your body. It also helps your body use some vitamins, such as vitamin A, D and E.

    The chemicals in bile can sometimes form lumps of solid material, known as gallstones. The stones vary in size. Some people have gallstones without realising it because they don’t have any symptoms. But sometimes gallstones, even very small ones, can irritate your gallbladder.

    You may need to have 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) li>
    • blocking the opening (bile duct) from your pancreas, causing pancreatitis

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

    Preparing for gallbladder 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. It can also make your surgery less effective and lead to complications.

    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.

    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. Follow your anaesthetist’s or surgeon’s 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 may 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 such as tinzaparin or dalteparin as well as or instead of wearing compression stockings.

    What happens during gallbladder removal?

    Most gallbladder removal operations are done as keyhole surgery under general anaesthesia. If you have your gallbladder removed with keyhole surgery, you’ll usually be able to go home on the same day.

    Once the anaesthetic has taken effect, your surgeon will make small cuts in your tummy (abdomen). They’ll then gently inflate your tummy using carbon dioxide gas to create space and 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. They’ll be able to see your internal organs on a monitor. Your surgeon will insert instruments through the cuts to remove your gallbladder.

    At the end of the operation, the carbon dioxide gas is allowed to escape so your tummy deflates and goes back to normal. Your surgeon will remove the laparoscope and other instruments. They’ll 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 you may need open surgery instead. This is where one larger cut is made in your abdomen to remove your gallbladder. Open surgery may be planned in advance, if there are known reasons why you can’t have keyhole surgery. But occasionally, your surgeon may need to convert 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.

    What to expect afterwards

    Pain and discomfort

    After having your gallbladder removed, you’ll need to rest until the effects of the anaesthetic have worn off. You may then need pain relief to ease any discomfort.

    If you have keyhole surgery, you may notice some discomfort and bloating caused by the carbon dioxide gas that was put into your tummy during the operation. This can also cause pain in your shoulder, but it usually gets better within around 48 hours.

    Going home

    If you’ve had keyhole surgery as a day procedure, you’ll usually be able to 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’ll have up to four small wounds on your tummy following keyhole surgery. Before you go home, your nurse will give you some advice about caring for them. You may be given some antibiotics to take to reduce your chances of getting an infection. You may be given a date for a follow-up appointment, usually around two weeks after your operation.

    You may feel particularly 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.

    Stitches

    Your surgeon may have used stitches that dissolve on their own to close your wounds. If your wounds are closed with metal clips or non-dissolving stitches, these will be removed by a nurse after about a week. Ask before you go home which type of stitches you’ve had and when they’ll need to be removed.

    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. Doing too much too soon could mean it takes you longer to recover.

    If you have an open operation with a large cut to your tummy, 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. 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. Check your insurance policy though, as some companies won’t insure you for a specific number of weeks after surgery. You shouldn’t drive if you’re taking any painkillers that cause sedation (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 if you notice any pain or soreness.

    You’ll usually have a follow up appointment two weeks after your keyhole surgery. Your surgeon will check your wound and look for any signs of jaundice (yellowing skin and eyes). They’ll also ask if you’re in any pain and whether you’re back to eating normal foods without feeling or being sick.

    Diet after gallbladder removal

    You shouldn’t need to eat a special diet after gallbladder surgery. You should be able to eat normal foods again as soon as you feel like doing so.

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

    You no longer need to avoid any foods that triggered your gallstone symptoms. If you still notice any symptoms when you eat these foods, contact your GP because you may have another condition that’s causing the symptoms. If fatty foods irritate your digestive system, eating a low-fat diet may help.

    Some people experience diarrhoea after gallbladder surgery. Your doctor may suggest several changes to your diet, including eating high-fibre foods. For more information, see our FAQ on Diarrhoea.

    Side-effects of gallbladder removal

    Gallbladder surgery can cause some side-effects. These include:

    • pain around your wounds
    • shoulder pain
    • tummy pain
    • bloating and discomfort in your tummy
    • diarrhoea
    • flatulence (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 GP or contact your surgeon before your follow-up appointment.

    Complications of gallbladder removal

    Most people don’t have any complications from gallbladder surgery. Keyhole surgery causes few complications and has a faster recovery time than open 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 bile duct. Damage to one of your bile ducts 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. These can include your stomach or intestine.
    • Postcholecystectomy syndrome. Up to four in every 10 people develop digestive symptoms such as long-term diarrhoea, indigestion, wind, bloating and pain, known as postcholecystectomy syndrome. Postcholecystectomy syndrome is usually a temporary problem.

    If you develop any complications 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 tummy. You’ll only have open surgery if it’s not possible to complete your operation safely using the keyhole technique.

    If you have any complications or feel very unwell after your operation, it’s really important that you get medical help and follow your surgeon’s advice. You may need medicines or further treatment.

    Frequently asked questions

    • Everyone recovers differently from surgery. You should recover more quickly from keyhole surgery than open surgery. But how soon you can go back to work will depend on the time it takes you to heal and also the type of job you do.

      If you have your gallbladder removed using keyhole surgery, you’ll usually be able to go back to work after around two weeks. If you have your gallbladder removed using open surgery, it may be up to eight weeks before you can go back to work. It’s important to follow your surgeon’s advice.

      Any type of surgery can make you feel more tired than usual for a few weeks afterwards. You may need to work fewer hours at first until your energy levels come back. But if your work involves heavy lifting, standing or walking, it may take you longer to return to your usual routine. It's important to remember that everyone is different – some people may need to rest for longer, others may recover more quickly. Speak to your employer and surgeon to decide what’s right for you.

    • Around one in 10 people get diarrhoea after having their gallbladder removed. Doctors don’t know exactly why this happens, but it’s thought to be caused by changes in the way bile flows around your digestive system. After surgery, more bile drains directly into your bowel, which then makes more water and salt than usual. This causes chronic (long-term) diarrhoea.

      If you have diarrhoea for a long time, this can be very distressing. But there are some things you can do to help yourself. Eat high-fibre foods such as brown rice, wholemeal bread and pasta and plenty of fruit and vegetables. This will help to absorb excess water and bulk up your stools, 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 prescribe some medicines to ease your symptoms. You can also be referred to a dietitian for some one-to-one advice.

    • ERCP stands for endoscopic retrograde cholangio-pancreatography. It’s a procedure that can be used to remove gallstones in your bile duct. An ERCP can also prevent inflammation, infections and blockages.

      You can have an ERCP done as an outpatient, which means you don’t have to stay in hospital overnight. You’ll have to fast overnight before the procedure though. You’ll usually have the procedure under sedation and local anaesthesia. This relieves anxiety, helps you relax and stops you feeling pain. It’ll usually be done by a gastroenterologist (a doctor specialising in conditions affecting digestive and liver conditions).

      Your gastroenterologist will use a narrow flexible tube, with a telescopic camera, called an endoscope. They’ll pass this through your mouth and down into your stomach to reach the place where the bile duct opens into your intestine. They’ll then inject dye down a tube inside the endoscope and take an X-ray. The dye helps to show up the gallstones.

      Your gastroenterologist will then be able to locate and remove the gallstones. Your gastroenterologist can also put in very small drainage tubes, called stents, which help the bile to flow around a gallstone.

      When the procedure is finished, you may need to rest until the effects of the sedative have worn off. You will be able to go home when you feel ready, but do make sure someone can take you home.


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    • Reviewed by Pippa Coulter, Specialist Health Editor, Health Content Team, September 2017
      Expert reviewer, Dr Yiannis Kallis, Consultant Hepatologist and Gastroenterologist
      Next review due September 2020



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