GALLBLADDER REMOVAL

General Information

DEFINITION--Removal of the gallbladder.

BODY PARTS INVOLVED--Gallbladder; bile ducts.

REASONS FOR SURGERY

• Gallstones.
• Suspected gallbladder tumors.
• Chronic gallbladder infection.
• Sudden, severe infection of the gallbladder that does not respond rapidly to treatment.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Recent or chronic illness, especially: alcoholism; cirrhosis of the liver; diabetes mellitus; heart disease; calcification of the gallbladder; or chronic obstructive pulmonary disease (COPD).

What To Expect

WHO OPERATES--General surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood studies; x-rays of the gallbladder; ultrasonic screen (See Glossary).
• During surgery: Cholangiogram (See Glossary).
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made under the right rib cage. Abdominal muscles are separated to expose abdominal organs, which are inspected for undetected disease. Other surgeries may be performed at this time.
• The gallbladder is cut free and removed from under the liver.
• A cholangiogram is done to determine if gallstones are lodged in the bile ducts. If necessary, the gallstones are removed.
• The incision is closed with sutures, skin clips or staples, which usually can be removed about 1 week after surgery. Frequently, 2 tubes are left in place. One connects the common bile duct to the outside, and another allows wound drainage.
• Sometimes, a tube running through the nose to the stomach remains at least 2 to 3 days after surgery until the gastrointestinal tract begins functioning again. Once normal intestinal function begins, the tube is removed and the patient can begin eating.
• Note: Endoscopic removal of the gallbladder is now the preferable surgery in suitable candidates (see Gallbladder Laparoscopy in Surgery section).

POSSIBLE COMPLICATIONS

• Internal bleeding.
• Peritonitis.
• Surgical-wound infection.
• Inadvertent injury to the common bile duct.

AVERAGE HOSPITAL STAY--5 to 7 days.

PROBABLE OUTCOME--Expect complete healing without complications. The surgery relieves symptoms in 90% of patients. Allow about 3 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap.

MEDICATION--You may use non--prescription drugs, such as acetaminophen, to relieve minor pain.

ACTIVITY

• Take short walks as soon as possible.
• Resume driving 18 days after returning home.
• Resume sexual relations when able.

DIET---Your doctor will prescribe a diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience new symptoms, such as hiccups, constipation or abdominal swelling.
• You develop signs of jaundice (yellow skin or eyes).