Surgical Facts

Gall Bladder Surgery

Relieving Your Pain.........

Gallbladder problems can cause severe stomach pain and other distressing symptoms. To relieve your pain, it may be necessary to remove your gallbladder. It could be removed through a single standard incision in your abdomen (open surgery). But your physician may have told you that you can have a newer type of gallbladder surgery. It's called laparoscopic cholecystectomy. People who have this procedure usually recover more quickly and have less pain than with open surgery.

A Gallbladder That No Longer Functions.........

It may have started after a meal: a steady, severe pain in your abdomen. You might have had bloating, nausea, or vomiting. This may have been your first attack or one of many. Your doctor has told you the likely cause of your pain is gallstones. This means your gallbladder is not longer functioning properly. And your symptoms may worsen if it isn't removed. So now you're thinking about surgery.

Treated Through Small Incisions.........

Laparoscopic cholecystectomy uses several small incisions instead of one large one. A laparoscope (a thin telescope-like tube) is inserted through one incision. It allows your doctor to view your gallbladder on a monitor. Your gallbladder is then removed through another small incision. The benefit of laparoscopy over open surgery include:

• less discomfort after surgery
• a shorter hospital stay
• a faster recovery (days instead of weeks)
• tiny scars instead of a long scar

The Gallbladder Anatomy.........

Hardly anyone thinks about their gallbladder unless it's causing problems. Your gallbladder stores bile, a fluid made by your liver. This fluid breaks down fats in the foods you eat and helps digestion. But gallstones can form and block the flow of bile into your digestive system. This results in pain and could lead to some series problems.

A Normal Gallbladder.........

Your gallbladder is a small, pear-shaped organ. It is located in the upper-right part of your abdomen under the liver. A healthy gallbladder removes water from bile and stores the bile for later use. When needed, the bile is squeezed through ducts into your small intestine to aid in digesting fatty foods.

How Bile Aids Digestion.........

• Your liver makes bile. It sends the bile to other parts of your digestive system through the hepatic and common bile ducts. Most bile is sent to the duodenum (the first part of the small intestine). Some bile is sent to the gallbladder.
• Your gallbladder stores a small amount of bile. When needed the gallbladder sends the bile to aid in digestion. Bile passes in and out of the gallbladder through the cystic duct.
• Your stomach and duodenum "tell" your gallbladder to release bile when you eat a fatty meal. Bile mixes with food in the duodenum. Your pancreas adds digestive juices. Digestion continues in the small intestine.

The Most Common Gallbladder Problem Is Gallstones.........

The amounts of bile and other fluids inside the gallbladder can become unbalanced. When this happens, some of the chemicals become solid and form gallstones. If the stones stay in the gallbladder, they may not cause any serious problems. But if the stones move and block ducts, bile can backup. This may lead to pain, nausea, and infections and diseases of the gallbladder, liver, or pancreas.

• In the gallbladder, gallstones may irritate the gallbladder wall. Or they may be "silent" and cause few or no symptoms.
• In the cystic duct, gallstones may cause a blockage. This may also cause upper abdominal pain, nausea, vomiting, heartburn, and back pain. The gallbladder can become infected.
• In the common bile duct, a gallstone can cause a blockage and pain. It can also cause jaundice (yellowing of the skin). Or, it can cause pancreatitis (an inflamed pancreas).

Evaluating Your Condition.........

Your physician will give you a physical exam You may also have one or more diagnostic tests. These tests help your physician find out if you have a problem with your gallbladder, These tests can also tell if you have gallstones and where they are located. Your doctor will then recommend the treatment that best meets your needs.

Medical History and Physical Exam.........

Your physician may ask you about symptoms, health problems, and risk factors that point to gallbladder disease. You'll also be given an exam to check your health and rule out other causes of the pain.

Diagnostic Tests.........

• Ultrasound: A painless test that uses sound waves to scan your abdomen for gallstones.
• Blood Tests: Can suggest stones in the common bile duct.
• Computerized Tomography (CT) Scan: Can be used to take cross-sectional pictures of your gallbladder.

Treatment Plan.........

You don't need your gallbladder to live a healthy life. So your physician may recommend surgery to remove it. Many people can have laparoscopic cholecystectomy instead of open surgery. But it may not be right for you if:

• You have major scarring from a past surgery.
• You have any bleeding disorders.
• You are pregnant and near your due date.
• You have a condition that will make it hard for your physician to see with the laparoscope.

Complications and Risks.........

Any gallbladder surgery has possible complications and risks. They may include the following:

• Excessive bleeding
• Infection
• Injury to surrounding organs
• Injury to the common duct
• Blood clots
• Injury to the lower digestive tract (rare)

Before Your Gallbladder Surgery.........

Don't take any pain medicines, such as aspirin or other blood-thinning medicines, for one week before surgery. To check your health, you may have blood tests and other tests a few days before surgery. Or, the tests may be given the day of the surgery. An anesthesiologist or nurse anesthetist may talk with you about the anesthesia that will be used to keep you free of pain during the surgery. Don't eat or drink anything after midnight the night before surgery. This reduces the risk of vomiting during surgery.

During Laparoscopic Surgery.........

First, you're given an anesthetic and medications through an IV (intravenous tube). Your abdomen is then inflated with carbon dioxide, a harmless gas. This helps your physician see and move inside your body. The gas is removed at the end of the surgery.

• Cholangiogram: During surgery, a cholangiogram (a particular type of x-ray) may be taken of your bile duct. The x-ray may reveal stones in the duct. Stones may be removed at this time or during a later procedure called Endoscopic retrograde cholangiopancreatography (ERCP).
• Open Surgery: Although unusual, your physician may feel it isn't safe to continue a laparoscopic cholecystectomy once it has begun. In that case, your gallbladder is removed through a larger incision in your abdomen (open surgery).

After Surgery Recovery.........

Most people go home the day of laparoscopic surgery and recover in less than seven days. There is usually less pain than after open surgery because the incisions are small and no muscles are cut. After you heal, the scars may be nearly invisible. The bile will still flow from your liver to your small intestine.

• In The Hospital: Small bandages will cover your incisions. The IV tube giving you fluids may stay in place briefly, until you can drink fluids. You may have some discomfort in your right shoulder for a short period of time. This will go away by itself. Within a few hours after your surgery, you may be drinking liquids. You may be able to eat a light meal later that evening if you wish.
• At Home: When you return home, you can do things that speed your recovery. Take your temperature often during the first 2 to 3 days to be sure you don't have a fever. Don't do any heavy lifting or vigorous exercise. Follow your physician's advice about showering, driving, and returning to work. You can usually return to normal activities in 3 to 5 days. Be aware that pain medicines can cause short-term changes in bowel habits, such as constipation. Bruising near the incision site is normal.
• Speeding recovery: You will be asked to cough and breathe deeply to keep your lungs clear. You'll also be asked to take short walks several hours after surgery. This keeps your blood circulating smoothly through your body. It also helps prevent blood clots from forming.
• Eating Normally Again: You may have some gas pains and other discomfort while your digestion returns to normal. During this short time, eat whatever was easy to digest before your surgery.
• Following Up: During the first week to 10 days after surgery, your physician will meet with you to check on your progress and answer your questions. If you have any stitches, they'll be removed. More appointments will be scheduled as needed.

Call Your Physician If.........

If you have any of the following side effects contact your physician immediately.

• Fever (over 101°F) or chills
• An incision that drains for longer than a day
• Increasing pain or redness at an incision site

NOTE: The material presented here is provided for informational and reference of the condition stated, and is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem.