Gallbladder removal

What is the gallbladder?

The gallbladder is a small organ under the liver. This pear shaped organ stores bile, a fluid helpful in fat breakdown made by liver. After ingestion of a meal containing fat, the gallbladder releases bile into the small intestine via the bile duct.

What is gallbladder removal?

Gallbladder removal (cholecystectomy) is the surgical procedure to remove the gallbladder. There are two methods of cholecystectomy:

Laparoscopic cholecystectomy

Laparoscopic surgery (also known as keyhole surgery) is one in which there are minimal incisions into the abdomen and a laparoscope (or scope) is used. A laparoscope is a thin tube with a light and camera on the end to allow the surgeon to see inside the body.

For this type of surgery, a surgeon makes a few small incisions on the skin and inserts the scope and other special tools through each of them. Then the surgeon uses the tools and the scope to do the surgical procedure.

Usually cholecystectomy is performed laparoscopically. However, in some cases open surgery might be necessary e.g. when the bile duct and gallbladder are scarred or too infected, making laparoscopic surgery unsafe.

Open cholecystectomy

Open surgery involves making a larger incision into the abdomen, big enough to see inside the body cavity easily and perform the surgery directly, without the help of laparoscope.

Why would a person have their gallbladder removed?

Cholecystectomy is usually performed to treat gallstones. Gallstones are small stones which form inside the gallbladder. These stones can cause symptoms like pain and inflammation. If they get into the bile duct, the flow of bile from the liver to the small intestine is blocked.

Cholecystectomy can also be performed to manage gallbladder cancer. However, if the reason of removal was cancer, then the surgery required involves removal of tissue other than the gallbladder as well.

What happens before gallbladder removal?

Before surgery, your doctor will:

  • Perform liver function tests to see if your liver functioning is normal
  • Perform an abdominal ultrasound scan (using sound waves to create an image of your body from inside) to see the presence of gallstones and whether the bile duct is enlarged or blocked
  • Perform an ERCP if the gallstone has blocked the bile duct. ERCP stands for "Endoscopic Retrograde Cholangio-Pancreatography". It’s a procedure performed using an endoscope, which is passed down to the first part of the small intestine through the throat. A camera and light on the endoscope allows the doctor to see the entrance of the bile duct. The doctor injects a special dye into the bile duct using this technique that shows up on X-ray, leading to the gallbladder, liver and pancreas and can allow stones to be seen. ERCP can also be used to widen the bile duct opening so that smaller stones can pass through or the endoscope may be used to physically remove some gallstones.
  • Intravenous antibiotics may be needed as a precaution to prevent post-surgical infection.

What are the benefits of gallbladder removal?

Gallbladder removal helps in relieving the symptoms of cholecystitis (gallbladder inflammation), gallstones and also in the management of gallbladder cancer.

What are the risks of gallbladder removal?

Cholecystectomy has a very low risk of:

  • Damage to bile duct near the gallbladder and liver
  • Leakage of bile
  • Bleeding
  • Damage to the intestines
  • Infection

What will my recovery be like?

Recovery is differs between laparoscopic and open surgery.

Laparoscopic surgery

Patients are usually discharged from the hospital on the same day or the next day. Although the incisions on skin are small, the procedure performed inside the body is the same as open surgery, therefore you won’t be able to do sports like swimming and heavy lifting for at least a week.

Open surgery

You’ll have to stay in hospital for around 1 to 2 days following open surgery. You’ll be asked to start walking as soon as possible and do deep breathing exercises. You can carry out routine activities but you’ll be advised to avoid sports and heavy lifting or swimming for at least week.

You might need a stool softener to prevent constipation if you’ve been taking narcotic pain killer medicine during the recovery period.

Call your doctor immediately if you experience any of these symptoms during the week following surgery:

  • Fever or chills
  • Swelling or redness around the surgical incisions
  • Nausea or vomiting
  • Severe belly pain or cramps
  • Bloating
  • Yellowish discoloration of eyes or skin

Will the surgery affect how my body breaks down food?

The surgery doesn’t have much effect on digestion, however 50% of people have mild symptoms including bloating or loose bowel movements but these usually improve on their own gradually.