Open gallbladder removal
Definition
Open gallbladder removal is surgery to remove the gallbladder through a large cut in your abdomen.
The gallbladder is an organ that sits below the liver. It stores bile, which your body uses to digest fats in the small intestine.
Alternative Names
Cholecystectomy - open; Gallbladder - open cholecystectomy; Cholecystitis - open cholecystectomy; Gallstones - open cholecystectomy
Description
Surgery is done while you are under general anesthesia so you will be asleep and pain-free. To perform the surgery:
- Your surgeon makes a cut in the upper right part of your belly, just below your ribs.
- The area is opened up so your surgeon can view the gallbladder and separate it from the liver.
- Your surgeon cuts the cystic duct and blood vessels that lead to the gallbladder.
- The gallbladder is lifted out and removed from your body.
An x-ray called a cholangiogram may be done during your surgery.
- To do this test, dye is injected into the cystic duct so that the dye flows into your common bile duct and an x-ray is taken. The dye helps find stones that may be inside the common bile duct.
- If other stones are found, your surgeon may remove them with a special instrument.
The surgery takes about 1 to 2 hours.
Why the Procedure Is Performed
You may need this surgery if you have pain or other symptoms from gallstones. You may also need surgery if your gallbladder is not working normally.
Common symptoms may include:
- Indigestion, including bloating, heartburn, and gas
- Nausea and vomiting
- Pain after eating, usually in the upper right or upper middle area of your belly
The most common way to remove the gallbladder is by using a medical instrument called a laparoscope (laparoscopic cholecystectomy), done through small incisions. Open gallbladder surgery is used when laparoscopic surgery cannot be done safely. In some cases, the surgeon needs to switch to an open surgery if laparoscopic surgery cannot be successfully continued.
Other reasons for removing the gallbladder by open surgery:
- Unexpected bleeding during the laparoscopic operation
- Obesity
- Inflammation of the pancreas (pancreatitis)
- Pregnancy (third trimester)
- Severe liver problems
- Past surgeries in the same area of your belly
- Severe inflammation of the gallbladder
Risks
Risks of anesthesia and surgery in general are:
- Reactions to medicines
- Breathing problems
- Bleeding, blood clots
- Infection
Risks of gallbladder surgery are:
- Damage to the blood vessels that go to the liver
- Injury to the common bile duct
- Injury to the small or large intestine
- Inflammation of the pancreas
Before the Procedure
Your may have the following tests done before surgery:
- Blood tests (complete blood count, electrolytes, liver and kidney tests)
- Chest x-ray or electrocardiogram (ECG), for some people
- CT scan of the abdomen that shows the liver and the gallbladder
- Ultrasound of the gallbladder
Tell your surgeon or nurse if :
- You are or could be pregnant
- You are taking any medicines, including medicines, drugs, supplements, or herbs you bought without a prescription
- You have been drinking a lot of alcohol, more than 1 or 2 drinks a day
Planning for your surgery:
- If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the provider who treats you for these conditions.
- If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots . Ask your provider for help quitting smoking.
- If needed, prepare your home to make it easier to recover after surgery.
- Ask your surgeon if you need to arrange to have someone drive you home after your surgery.
During the week before your surgery:
- You may be asked to stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
- Ask your surgeon which medicines you should still take on the day of your surgery.
- Prepare your home for any problems you might have getting around after the surgery.
- Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes outbreak, or other illness. If you do get sick, your surgery may need to be postponed.
On the day of surgery:
- Follow instructions about when to stop eating and drinking.
- Take the medicines your surgeon told you to take with a small sip of water.
- Shower the night before or the morning of your surgery.
- Follow instructions on when to arrive at the hospital. Be sure to arrive on time.
After the Procedure
You may need to stay in the hospital for 2 or more days after open gallbladder removal. During that time:
- You may be asked to breathe into a device called an incentive spirometer. This helps keep your lungs working well so that you do not get pneumonia.
- Your nurse will help you sit up in bed, hang your legs over the side, and then stand up and start to walk.
- At first, you will receive fluids into your vein through an intravenous (IV) tube. Soon after, you will be asked to start drinking liquids. Eating solid foods may be delayed.
- You won't be able to shower right away while you are still in the hospital. Your care team will tell you when to begin.
- You may be asked to wear pressure stockings on your legs to help prevent a blood clot from forming.
If there were problems during your surgery, or if you have bleeding, a lot of pain, or a fever, you may need to stay in the hospital longer. Your surgeon or nurses will tell you how to care for yourself after you leave the hospital.
Outlook (Prognosis)
Most people have good results from this procedure. It will take several weeks to heal from the open incision and to regain your usual energy.
References
Bonds M, Rocha F. Cholecystectomy techniques and postoperative problems. In: Jarnagin WR, Allen PJ, Chapman WC, et al, eds. Blumgart's Surgery of the Liver, Biliary Tract, and Pancreas. 7th ed. Philadelphia, PA: Elsevier; 2023:chap 36.
Radkani P, Hawksworth J, Fishbein T. Biliary system. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 55.
Reviewed By: John Meilahn, MD, General Surgeon, Wyndmoor, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
All rights reserved.