Some frequently asked questions...
What is a gallbladder?
The gallbladder sits just below the liver on the upper right side of the abdomen. It is a small, pear-shaped, pouch-like organ that stores and releases bile that helps your body break down food.
If people have too much of a liver pigment called bilirubin in the bile or excess cholesterol, they may experience gallbladder problems or gallstones. Symptoms can include:
- Sharp pain in your abdomen,
- Nausea and vomiting,
- Fever, and
- Yellow skin – Jaundice is the medical term for skin and eyes that look yellow. You might get jaundice if gallstones block your bile duct.
In cases where these symptoms do not subside and become too uncomfortable or interfere with everyday life, your specialist surgeon may suggest either open or laparoscopic gallbladder removal. Fortunately, you can live a healthy life without your gallbladder and the surgery to remove it is relatively simple.
What is the difference between open and laparoscopic gallbladder removal?
The procedure to remove the gallbladder is called a cholecystectomy and the most common method is 'keyhole surgery' or laparoscopic gallbladder removal or laparoscopic cholecystectomy. The procedure is performed by inserting a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder.
The good thing about laparoscopic cholecystectomy is that you can usually go home on the day of the operation or the morning after and any pain can be treated with Paracetamol or anti-inflammatory medications.
In some cases, one large incision may be used to remove the gallbladder. This is called an open cholecystectomy. During an open cholecystectomy, the surgeon makes a 15 cm incision in your abdomen below your ribs on your right side. The muscle and tissue are pulled back to reveal your liver and gallbladder. Your surgeon then removes the gallbladder.
An open cholecystectomy takes one or two hours, and you can expect to spend two or three days in hospital recovering. Once at home, it may take four to six weeks to fully recover.
Your surgeon will use their best judgment about the safest surgery for you.
What preparation is required in advance of surgery?
Prior to your surgery Kensington Hospital will provide you with instructions on when you should stop eating and drinking. Your stomach must be empty for at least 6 hours in order to make the general anaesthetic safe. They will also give you directions where to present for surgery and your actual admission time.
If you take tablets to thin the blood such as Aspirin, Warfarin or Clopidogrel, then you need to let your surgeon know as they may need to be stopped prior to surgery.
It is okay to continue to take your regular medication with a small sip of water on the morning of your surgery. If you are unsure, please ask.
Also refer to Kensington Hospital patient information available here - https://www.kensingtonhospital.co.nz/patient-information/
What complications can occur?
Like any abdominal surgery, gallbladder removal or cholecystectomy carries some risks. Even though infrequent, it still carries the same risks as general surgery. Complications may include:
- Bleeding and infection may occur.
- In a few cases, the gallbladder may not be able to be safely removed by laparoscopy and an open cholecystectomy is then immediately performed.
- Blood clots
- Nausea and vomiting may occur after the surgery.
- Injury to the bile ducts, blood vessels, or intestine can occur, requiring corrective surgery.
Some ways you can prevent complications after surgery include:
- Drink plenty of fluids to prevent dehydration.
- Walk around frequently to prevent blood clots.
- Wash your hands before and after touching the area around your incision site(s)
- Don’t lift more than 4 kg for 4-6 weeks.
- Change your bandages as directed.
- Avoid wearing tight clothing that could rub against the incision.
What happens after the gallbladder removal?
Once the gallbladder has been removed, most people make a full recovery and function normally. However, about 4% of people become intolerant to fatty foods and experience bloating, flatulence, colicky discomfort and diarrhoea and may have to eliminate fatty foods from their diet. Usually the bowel adjusts, and most people find they can take a normal diet within 6-8 weeks of surgery.
- After surgery, key symptoms to watch out for are:
- fever or chills
- increasing pain or redness around the incision
- drainage from the incision site(s)
- not passing a bowel movement for 2-3 days after surgery.
If you get any of these, contact your doctor or surgeon straight away.
When can I return to work?
Your return to work depends on the type of surgery you have, how you are feeling and the type of work that you do. If you have laparoscopic gallbladder removal and you have a relatively sedentary job, then you may feel ready to return within 3-4 days. If you are involved in manual labour or heavy lifting, you need to avoid straining for at least two weeks.
You will have a follow-up appointment with your surgeon approximately six weeks after your surgery to assess your recovery, discuss any concerns that you may have and to review the pathology of the gall bladder.
If you have any concerns or problems prior to this appointment, please contact our rooms to discuss, or if you are acutely unwell then you need to go to your nearest hospital emergency department and leave a message with our rooms.