Patient education: Cholecystectomy (The Basics)

What is cholecystectomy? — Cholecystectomy is surgery to remove the gallbladder (figure 1). The gallbladder is a small, pear-shaped organ that is tucked under the liver. It stores bile, a fluid that is made in the liver and helps the body break down fat. When you eat a meal that has fat in it, the gallbladder empties the bile into a tube called the "bile duct." The bile duct carries the bile into the small intestine to help with digestion.

The most common reason that people have this surgery is to treat gallstones. These are small stones that form inside the gallbladder. They can block the bile duct and cause symptoms.

This surgery can be done in 2 ways:

●Open surgery – During an open surgery, the doctor makes a cut, or "incision," in the belly to remove the gallbladder.

●Minimally invasive surgery – "Minimally invasive" surgery lets the doctor make smaller cuts in the belly. They insert long, thin tools through the cuts. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the belly. Then, they use the long tools to do the surgery. They can control the tools directly, or with the help of a robot (this is called "robot-assisted" surgery). Minimally invasive surgery is the most common way that doctors remove a gallbladder.

You might be able to return to normal activities sooner if you had minimally invasive surgery than if you had an open surgery.

In rare cases, the doctor might start with minimally invasive surgery, but have to change to an open surgery.

How do I prepare for cholecystectomy? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might order tests, such as:

●Blood tests to check if your liver is working normally

●Ultrasound or other scan – This can show if you have gallstones and if your bile duct is enlarged or blocked.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems or surgeries you have or had in the past, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or over-the-counter medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●When to stop eating or drinking before your procedure

●Making sure that you have a way to get home after your procedure

●Washing your hair and body with a special soap before you come to the hospital. If you need to remove hair, clip the hair with scissors or electrical clippers. Do not shave the area with a razor.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during cholecystectomy? — During your procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you are not aware and do not feel pain during the procedure. When you have your gallbladder removed, you will have general anesthesia. This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. You might get a breathing tube to help you breathe.

●The doctor will put a small tube in your mouth or nose during the surgery. This tube goes down to your stomach to drain out any food or fluid. This is taken out at the end of the surgery.

●The doctor might put a thin, flexible tube called a "catheter" into your bladder. This is to drain urine during the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will take out your gallbladder. They might also check for gallstones in the bile ducts.

●In some cases, the doctor might leave a drain tube in your belly to get rid of any extra fluid. The drain is often taken out while you are still in the hospital. If you have to go home with the drain in place, the doctors and nurses will teach you how to care for it.

●The doctor will close the incisions and cover them with clean bandages.

●The surgery can take up to 2 hours.

What happens after cholecystectomy? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. You might go home the same day, or you might need to stay in the hospital for a day or 2.

As you recover:

●Because you had general anesthesia, you might feel groggy or confused for a short time. You might also nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a tube in your bladder, it will be removed.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of cholecystectomy? — The risks of cholecystectomy are low. However, some people have:

●Damage to other bile ducts near the gallbladder

●Bile leaks

●Bleeding

●Damage to the intestines

●Infection

●Gallstones that are "trapped" in the bile duct – These would need to be removed with a different procedure after surgery.

In some cases, a person will continue to have belly pain even after the gallbladder is removed.

What else should I know? — Cholecystectomy does not affect digestion very much. But some people who have surgery have mild symptoms afterward. These can include loose bowel movements, gas, or bloating. These symptoms usually get better.

Before you go home from the hospital, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Cholecystectomy – Discharge instructions (The Basics)
Patient education: Choosing surgery to treat gallstones (The Basics)
Patient education: Gallstones (The Basics)
Patient education: Acute pancreatitis (The Basics)
Patient education: Endoscopic retrograde cholangiopancreatography (ERCP) (The Basics)

Patient education: Gallstones (Beyond the Basics)
Patient education: Acute pancreatitis (Beyond the Basics)
Patient education: Chronic pancreatitis (Beyond the Basics)
Patient education: ERCP (endoscopic retrograde cholangiopancreatography) (Beyond the Basics)