Cholecystectomy or Gallbladder Removal Surgery

The gallbladder is a four-inch organ located in the upper-right area of the abdomen, under the liver. It helps produce, store, and transport bile, a yellowish-brown fluid produced by the liver.

This fluid is responsible for digesting and breaking down food with fats.

When problems arise, if first-line treatments do not work, and the issue is persistent, doctors may recommend removal to prevent further complications.

Though the gallbladder is a component of the biliary system, it is not considered to be an essential organ. Bile fluid can find it’s way directly to the small intestine through ducts in the liver.

Types of Surgery:

The procedure for removal of the gallbladder is called Cholecystectomy. Two types of procedures come under cholecystectomy:

Laparoscopic Cholecystectomy

This is the most common choice of surgery used to remove over 95% of gallbladders. This method is less invasive and entails 3 to 4 small incisions.

The procedure involves the use of a small tube through the incision. This tube holds a camera (called a laparoscope) along with surgical devices.

The surgeon extracts the gallbladder through one of the incisions.

Open Cholecystectomy

A conventional method that involves making a single large incision at the site and extracting the gallbladder through it.

Why Remove the Gallbladder?

There could be many reasons to opt for gallbladder removal. There could be blockages due to bile being thick or even deposits of hard substances known as gallstones.

Mostly, these gallstones pass naturally. Your doctor may recommend surgery if there is notable pain or larger stones.

Other reasons for cholecystectomy could be: 

• Inflammation in the gallbladder or pancreas
• Gallstones stuck in the bile duct causing further complications for the biliary system
• Improper functioning of the gallbladder itself
• Increased risk of Cardiovascular Diseases (observed from a study where participants with gallbladder disease had a 23% increased risk of CVD)

Common factors that could increase the risk of gallbladder problems are: 

• High cholesterol
• Sudden and rapid weight loss (especially people with bariatric surgery)
• Diabetes
• Hypothyroidism
• Age
• Family history

Risk

Gallbladder removal is a low-risk and frequently performed surgery. While any form of surgery has threats, the risk of not having the procedure when recommended could be far worse.

Some of the possible gallbladder removal complications could be:

• Complications with anaesthesia
• Bile leaks
• Injury to surrounding organs
• Hernia (when the tissue of the organ pushes through the surrounding muscle)
• Numbness
• Infection

Above are general risks of a cholecystectomy procedure. However, each individual may face different risks depending on their history and body composition.

Preparation and Precautions

Disclose your complete history to your doctor and discuss any fears about complications that may arise.

If you smoke, let the surgical team know and plan on quitting before the surgery to decrease the risk of complications.

If you have a laparoscopic cholecystectomy, you would mostly be discharged the same day. An open cholecystectomy may need you to stay overnight for monitoring.

What to Expect

While your doctor will give you a comprehensive download, here are some things to keep in mind:

Before Surgery

• Your surgeon will explain the complete procedure to you.
• Along with a complete download of your medical history, you might be asked for blood reports and imaging.
• Disclose all the medication you have been taking, even if they are supplements.
• You would have to bring someone along to drive you to and from the hospital.
• You would be asked not to eat or drink around 8 hours before the procedure.

The Day of the Surgery

• You would be asked to take off all jewellery and belongings.
• They will place an IV line into your hand.
• In case there is a lot of hair growth around the surgical site, it may be clipped/shaved.

For Open Gallbladder Surgery:

You would be placed under anaesthesia, the surgery would be conducted, and if needed, fluid might be drained.

For Laparoscopic Cholecystectomy:

The surgeon will make incisions after anaesthesia. Carbon dioxide will be used to inflate your abdomen for easy visibility of organs.

Once the procedure is complete, the gas is let out through the incisions.

After Surgery

• You would either get a same-day discharge or admitted overnight.
• You would be monitored and given pain medication as suited.
• As per your condition, you may be given food and liquids a few hours after surgery.
• You would have a follow up scheduled a few weeks after for a review.

Symptoms

The following are common symptoms to watch out for:

• Sharp pain in the upper-right area of the abdomen (especially after heavy meals)
• Jaundice
• Nausea, bloating, and fever
• Visit a doctor if these symptoms persist.

Advantages of Gallbladder Surgery

Depending on the reason for surgery, the benefits may vary, but the general advantages of gallbladder surgery range from the following:

• Relief from pain
• Avoidance of further infection and complications
• Prevention of blockages and obstructions that could lead to other diseases like jaundice
• Prevention of gallstones from recurring
• Reduction in chances of Gallbladder Cancer (as noted from multiple studies that gall stones were present in 70–90% of patients with Gallbladder Cancer)

When to See a Doctor

Before Surgery

If you experience any of the above symptoms.

After Surgery

• If you develop a high fever (above 101°F) or chills
• Have pain that does not respond to medication
• See any abnormal discharge or if the surgical wound bleeds
• Find it hard to eat or drink
• Observe the yellowing of your skin or the whites of your eyes

Recovery

It is important to follow the instructions given by your doctor. Make sure to wash your hands and sterilize whenever caring for the wound. Avoid wearing tight clothing that might restrict the healing of the wound.

Patients usually take up to 3 weeks to return to normal activity. So, slowly increase your activity level and avoid abrupt exercises.

Further Care

Maintain the health of your biliary and digestive system by eating right and keeping fit. Ensure to add nutritious high-fibre food like fresh vegetables and whole grains.

Avoid eating high-fat meals and processed food to prevent overloading your system. Drink 8 to 10 glasses of water daily to stay hydrated.

Bottom Line

While the prevention of diseases with a healthy lifestyle should be your first priority, the cure for them is also advancing rapidly. If you have experienced any of the symptoms stated for a prolonged period, or are continually facing gastrointestinal issues, make sure to visit a doctor promptly.