GALLBLADDER SURGERY

Gallbladder removal is a very common procedure. Gallbladder surgery is done on a planned (also called “elective”) basis, or sometimes as an emergency.

There are a number of reasons why your doctor might recommend gallbladder surgery:

  • gallstones causing symptoms or pain attacks (“biliary colic” in medical terms)

  • gallstones causing inflammation or infection of the gallbladder (“cholecystitis” in medical terms)

  • gallstones leading to pancreatitis

  • gallstones in or blocking the common bile duct

  • non gallstone related inflammation or abnormal function of the gallbladder

There are a number of tests that your surgeon may use to check the gallbladder. The most common tests include:

  • ultrasound

  • CT scan

  • HIDA scan

Gallstones and Symptoms

Gallstones are very common, and not everyone with gallstones has symptoms because of their gallstones or requires removal of the gallbladder. Some individuals will have gallstones found on ultrasound or CT scans completed for other reasons.

Common symptoms of gallstones include:

  • pain in the mid to upper abdomen after eating

  • pain in the right upper portion of the abdomen under the ribs

  • nausea or vomiting

  • pain across the upper abdomen just underneath the ribs

  • pain from the right upper abdomen that shoots around to the back or towards the right shoulder blade

What does your gallbladder do?

Your gallbladder stores bile made by your liver. When you eat, your gallbladder gets a signal to squeeze the bile down the bile duct which empties into the bowel. The bile mixes with your food to help you digest.

What to expect when having gallbladder surgery

Gallbladder surgery on an “elective” or planned basis is typically a day surgery. This means that you come to the hospital for your surgery and then go home afterwards to sleep in your own bed that evening. The procedure itself usually takes between 1-2 hours, and there is some time spent going to sleep under anesthesia prior to the procedure and then waking up afterwards.

Most patients have manageable pain that can be controlled with common over the counter painkillers such as tylenol and advil (ibuprofen) taken on a regular schedule for the first 3-7 days after the surgery. Your surgeon may offer you a prescription of a stronger opioid painkiller just in case tylenol and advil are not enough to manage your pain. You should be comfortable enough to get up and move around after surgery, though will have some discomfort in the abdomen.

Your stitches after gallbladder surgery are usually self dissolving and located under the skin. There are typically no sutures to be removed.

You can shower 36-48 hours after gallbladder surgery and pat your bandages dry. You are recommended to avoid submerging the incisions in a bath, hot tub, or swimming pool for 2-3 weeks after surgery, until the cuts are fully healed.

You will have small bandages called steri-strips on your cuts. These steri-strips should be removed 10-14 days after surgery if they have not fallen off on their own. It can be helpful to take these bandages off in the shower, letting the water loosen bandages. Do not worry if your bandages fall off prior to 10-14 days after surgery. The skin heals quickly and it is only necessary to cover the cuts for the first few days after surgery.

This website from Ontario outlines gallbladder surgery nicely:

Risks of Gallbladder Surgery

There are a number of risks and complications associated with gallbladder surgery. Many of these risks are risks common to any surgery within the abdomen. Most patients do not experience any of these difficulties, however patients can rarely have a serious complication during their surgical course.

Risks of gallbladder surgery around the time of surgery include but are not limited to:

  • allergic or adverse reaction to anesthesia

  • serious heart or lung problems such as heart attack, stroke, or pneumonia (less than 1%)

  • bleeding or the need for blood transfusion (less than 1%)

  • blood clots in the legs or the lungs (less than 1%)

  • infection

  • injury to another structure in the abdomen such as a piece of bowel, blood vessels, or the liver (less than 1%)

  • hernias at any of the incisions

  • a change in approach to an open or traditional surgery with a larger incision and the surgeons placing their hands inside the abdomen (less than 5%)

  • injury to the bile duct or bile leakage - older studies suggested this risk was about 0.5% but we believe this rate to be much lower, likely in the range of 0.2% or less (1/500 or less)

  • death (<0.1%)

While rare, injury to the bile duct, or injury to other intraabdominal organs such as bowel or blood vessels are the most harmful complications that can occur. Bile duct injury, if it were to occur can require further surgery for either an immediate, or delayed surgical repair, or could require further procedures such as ERCP or specialized radiology procedures to drain the bile duct system. Injury to blood vessels, bowel, or other organs typically requires further surgery for repair.

Long term risks

In the long term, most patients do not experience any side effects after gallbladder removal. A small percentage of patients will have diarrhea after surgery which usually clears up on its own. In patients who experience diarrhea after gallbladder removal that does not resolve with time, there is medication for treatment.

After gallbladder surgery, some patients will find that they experience diarrhea or loose stools if they eat very rich or fatty meals as their ability to fully digest a large fatty meal is slightly diminished. This is not dangerous though the diarrhea or loose stool can be unpleasant. Eating a low fat diet can help to control these symptoms.