Gallbladder removal

Gallbladder removal surgery (cholecystectomy) is a common operation to treat gallstones and other gallbladder problems. It is usually keyhole (laparoscopic) surgery, although rarely people can need open surgery – usually when the surgeon has to switch to this during a keyhole operation.

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 to use some vitamins.

You may need gallbladder removal surgery if you have a disease that affects your gallbladder – most commonly gallstones that are causing symptoms. Aside from gallstones surgery, other reasons to have gallbladder removal include to take out polyps or cancer.

The operation to remove a gallbladder is called a cholecystectomy (pronounced co-le-sis-tec-tomy). The formal name for this keyhole surgery is laparoscopic (pronounced la-paro-sco-pic) cholecystectomy. If your surgeon needs to make a bigger cut, when your tummy (abdomen) is opened, it’s called an open cholecystectomy.

Preparing for gallbladder removal

Your surgeon will discuss with you what will happen before, during, and after your gallbladder 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 and happy to give your consent for the gallbladder removal to go ahead. Your surgeon will ask you to sign a consent form.

Your surgeon will explain the steps you can take to prepare for your operation, and to help your recovery after the surgery.

• If you smoke, try your best to stop. Smoking increases your chances of getting an infection after surgery, which can slow down your recovery.
• Your surgeon may advise you to eat a low-fat diet to help reduce pain from your gallstones.
• They may advise you to lose some excess weight before your operation, to reduce the risks of surgery.
• If your weight is high, your surgeon may also advise you to eat a very low-calorie diet for two weeks before surgery. This is to reduce the size of your liver and make it easier to access the gallbladder.
• You may need to wear compression stockings to help prevent blood clots forming in the veins in your legs, which can lead to deep vein thrombosis. If staying in hospital overnight, some people may need to have an injection of an anti-clotting medicine as well as, or instead of, wearing compression stockings.
• You’ll have gallbladder removal surgery under general anaesthesia. It’s important that you don’t eat or drink anything for six hours before your operation. You can usually drink water until two hours before. Check with your anaesthetist or surgeon, and always follow their advice on eating and drinking before your surgery.

If keyhole surgery is used throughout your gallbladder removal, you can usually go home the same day as your operation. But some people need to stay in hospital overnight or longer – if they had to have open surgery, for example.

Gallbladder removal procedure

It usually takes around an hour to have gallbladder removal surgery, but this can vary. Ask your surgeon how long it will take to do your operation. You’ll have your gallbladder removal under general anaesthesia . This means you’ll be asleep during the operation.

You’ll usually have keyhole surgery for your cholecystectomy. Your surgeon will make small cuts in your tummy (abdomen), or one slightly larger cut. They’ll then gently inflate your tummy with 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 at the tip) through one of the cuts. They’ll be able to see the inside of your tummy on a screen. Your surgeon will put instruments in through the cuts to take out your gallbladder.

When your surgeon has removed your gallbladder, they’ll allow the carbon dioxide gas to escape, and will remove the laparoscope and other instruments. Finally, they’ll close the wounds.

Open surgery

Occasionally, your surgeon may need to switch from a keyhole procedure to open gallbladder surgery during your cholecystectomy. They’ll need to make a large cut across the right side of your tummy for this. Your surgeon will explain the possibility of changing to open surgery before your procedure, when they ask you to give your consent.

Open surgery is the first approach for some people who have had lots of surgery on their tummy before, or have less common reasons to remove the gallbladder, like treating cancer.

Aftercare for gallbladder removal

Pain and discomfort

After gallbladder removal, 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 gallbladder surgery. Your hospital team will offer you pain relief if you need it.

You may have some discomfort caused by the carbon dioxide gas that is put into your tummy (abdomen) during a keyhole cholecystectomy. This can also cause pain in your shoulder, but it will usually get better within a couple of 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, a practice nurse will need to take these out after about seven to 10 days.

You may have a dressing over your wounds, or sometimes cuts may be left without a dressing on them. Your nurse will give you advice about how to care for your wounds.

Going home

If you’ve had keyhole surgery as a day procedure for gallbladder removal, 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 gallbladder surgery. You may feel a little tired or emotional after your operation. This is completely normal.

Having a general anaesthetic affects everyone differently. You may find that you get confused, and your memory might be affected too. This is usually temporary and most people make a full recovery. In the meantime, don’t drive, drink alcohol, operate machinery, or sign anything important. Always follow your surgeon’s advice.

Gallbladder removal recovery

Gallbladder removal recovery depends on your individual case.

You should be feeling better a week or two after a keyhole operation, but a full recovery will take longer if you needed open surgery.

Talk to your surgeon about when you’re likely to get back to your normal routine, and the long-term effects of gallbladder removal. Don’t do too much at once. It’s important to build up gradually and to stick to a routine if you can.

Eat healthily, rest when you need to, and don’t smoke – this will all help you to recover well.

If you need pain relief after your cholecystectomy, 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.

If you do take painkillers after your gallbladder surgery, some of these may make you constipated. Eat plenty of fibre-rich foods, such as fresh fruit and vegetables, to help with constipation.

Driving

You may not feel like driving for at least a week after your gallbladder removal surgery. Check your insurance policy, as some companies won’t insure you for a specific number of weeks after surgery. Don’t drive if you’re taking any painkillers that make you sleepy.

Going back to work

You’ll probably be able to go back to work around two weeks after keyhole surgery for cholecystectomy. But this will depend on how well you recover and the type of job you do. If you do a lot of walking, standing, or any heavy lifting in your job, you’ll probably need longer. Ask your surgeon for advice.

Gallbladder removal side-effects

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 and discomfort in your tummy (abdomen) and in your shoulder
• bloating in your tummy
• diarrhoea
• feeling tired

If you have any of these symptoms after surgery and they haven’t gone by your follow-up appointment, it’s important to tell your surgeon. If these potential gallbladder removal side-effects are particularly troublesome, contact your surgeon or speak to your GP.

Some people can develop loose bowel motions after gallbladder removal – thought to be due to changes in bile flow. This type of diarrhoea will often improve, but some people can need long-term treatment.

See our section Frequently asked questions for information about long-term side-effects of gallbladder removal.

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 gallbladder removal surgery include the following.

• Infection at the site of the operation (fewer than 5 cases in every 100 operations).
• Bleeding (under 2 cases in every 100 operations).
• Injury to your bile duct (under 1 in 200 operations).
• Bile duct injury is a rare but serious complication that happens during cholecystectomy. It can cause a blockage or bile leak in the days after surgery.
• Contact the hospital or your doctor urgently if you have a high temperature, severe tummy pain, or jaundice (yellowing skin and eyes).
• Post-cholecystectomy syndrome, which includes digestive symptoms, such as indigestion, feeling sick, and bloating.

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

Alternatives to gallbladder removal

If you have symptoms from gallstones, the main treatment is gallbladder removal surgery. But there are alternative treatments for gallstones.

For example, your doctor may advise you to make some changes to your lifestyle as an alternative to having a cholecystectomy. Avoid any food or drinks that you notice are making the pain from gallstones worse. You may need to eat a low-fat diet to help to prevent pain from gallstones too.

These diet changes are also the advice if you have gallstones in your gallbladder but without any symptoms.

If you have stones in your bile duct, treatment may include endoscopic retrograde cholangiopancreatography (ERCP). This uses a combination of endoscopy and X-rays to find and treat your bile duct stones.

It’s possible that you may still need to have an operation to remove your gallbladder. This is because there may be gallstones in the gallbladder after lifestyle and bile duct treatments.