What can I expect after laparoscopic gallbladder surgery?

Returning to normal may take a few days or weeks, depending on your body’s healing power. People can lead a normal, healthy life without the gallbladder.

Pain

There is usually minimal pain associated with this operation. The abdomen will be sore as well as the small incision sites, and some patients have shoulder pain for the first day or two. The shoulder pain is caused by gas left in your abdomen during the operation. It will disappear on its own. When you are discharged home you will be given a pain medication to take if necessary. The first few days you may want to take the pain medication so that you will be more comfortable. As you become more active the amount of pain medication needed should decrease quickly. Some patients find that after the initial recovery period is over that medications such as Tylenol or Ibuprofen work well. As with any type of surgery, it is reasonable to expect some amount of pain. This varies with individual patients and depends on your body’s response to pain medication.

Diet

Most patients are concerned about what they can eat after the cholecystectomy. You are permitted to eat what you would like. Most patients find that a bland diet of such foods as: toast, rice, bananas, soups, pasta etc. are the easiest to digest initially. After the initial recovery period most patients can tolerate a variety of foods without difficulty. It is not uncommon for it to take a few days for your normal appetite to return following surgery.

Wound Care

There will be four small wounds on your abdomen after the operation, three under your right ribs and one at the belly button. These wounds are usually closed with dissolvable stitches. These areas need to be kept clean. You may shower and bathe when the bandages are removed. You should look at the wounds every day and call the GI Surgery Nurse at (919) 966-8436 if there is redness or any bleeding from these areas. Sometimes you will notice bruising around the wounds, this is normal.

Driving a Car

As long as you are not taking pain medicine stronger than Tylenol or Ibuprofen and when you feel as though your reaction time is normal, you may begin driving. Do not drive if you are taking any kind of pain medicine or medicine that impairs your judgment. Most patients wait until they no longer feel their abdomen is sore.

Work

Most patients feel strong enough to return to work in a 1 to 2 weeks following the operation. Some patients may return sooner if they do desk work. If you do work that requires you to lift or bend then you may need to be placed on restricted work duty until you have your post-operative appointment. If you need a letter or work excuse to be sent to your employer, please let your surgeon or the GI Surgery nurse know.

Bowel Habits

Normal bowel habits may be altered by several factors regarding surgery. Constipation is common. Anesthesia, decreased activity, and narcotic pain medications are factors that may cause constipation. You should be aware to increase fiber in your diet as soon as possible and to increases your fluid intake. If necessary you may take a mild laxative. Infrequently patients develop loose stools or diarrhea after a cholecystectomy. This may go away within days or may last for several weeks. This is easily treated with medication.

Activity and Exercise

Patients feel like doing activities within a few days of having their operation. You should not lift anything heavier than 8 to 10 pounds (a gallon of milk) for 2 weeks. After this period of time you can begin lifting heavier objects being aware that if your abdomen hurts you should not be lifting. Walk as much as is comfortable for you, moderate exercise helps improve circulation. You may shower the day after the operation. You may resume sexual relations when it feels comfortable for you.

Potential Problems

As with any operation there is a possibility of complications. Included in these complications are bile leaks and/or bile duct injuries. Although these can be serious complications, they occur very rarely. Your surgeon will discuss these with you.

Some potential short-term complications that may arise shortly after the operation are:

Loose bowel movements – may occur because bile is not being concentrated in the gallbladder, it is spilled directly into the small intestine from the liver. It often takes a few days to a few weeks for your body to adjust. If the symptoms become severe, you should notify the surgeon or the GI Surgery nurse.

• Infection – infection can occur with any operation. Every step is taken to ensure that this does not take place.
• Wound infection – these infections are usually superficial or on the surface, and can be treated by draining the infected site.
• A long term complication that may arise months or years after your operation is a:   Hernia – A hernia is a protrusion of tissue through a weak spot in your incision. Hernias are not common after laparoscopic surgery, but do occur. An operation is necessary to repair the hernia.

Conclusion

Most patients feel much better following this operation. The gallbladder is an important organ, but not essential for life. The surgeons here at UNC Hospitals have been performing this procedure since its inception. They have experience in all aspects of care regarding patients with gallstones. We encourage you to speak to patients who have had this operation. We are glad to give you the names of previous patients who are willing to talk to potential patients.

This information is being provided to help patients understand laparoscopic cholecystectomy. You should talk with your physician about any medical advice dealing with your medical diagnosis.

A laparoscopic cholecystectomy is surgery to remove your gallbladder.

The surgeon makes a few small incisions on the right side of your abdomen (belly). The surgeon uses one incision to insert a laparoscope, a thin tube with a camera on the end. This shows your gallbladder on a screen. The gallbladder then gets removed through another small incision.

A laparoscopic cholecystectomy is less invasive than an open cholecystectomy. This other form of gallbladder removal involves a larger incision.

What is the gallbladder?

The gallbladder is an organ the shape and size of a small pear. It stores a substance called bile made by the liver. It keeps the bile until the body needs it to digest fatty foods.

Who needs to have gallbladder removal?

A laparoscopic cholecystectomy helps people with gallstones that are causing pain and infection.

Gallstones are crystals that form in the gallbladder. They can block the flow of bile out of the gallbladder into your digestive system. This roadblock causes cholecystitis (inflammation of the gallbladder). Gallstones can also move to other parts of the body and cause problems.

Symptoms of gallstones include:

• Feeling bloated.
• Fever.
• Jaundice (yellow-looking skin).
• Nausea.
• Pain in the right side of the abdomen, which may reach the back or the shoulder.

Before the procedure, your healthcare team will perform certain tests, such as:

• Abdominal ultrasound.
• Blood work.
• Urinalysis (evaluation of the urine).

They will also talk to you about:

• Any medications you are taking.
• Your options for controlling pain during and after surgery.
• Your surgeon may ask you to avoid food and liquid for a few hours before the procedure.

What happens right before laparoscopic cholecystectomy?

You will receive general anesthesia so that you sleep and have no pain during the procedure. Once you’re out, your healthcare providers will place a tube down your throat to help you breathe. They’ll place another tube — an IV line — in your arm to deliver fluids and medications.

What happens during laparoscopic cholecystectomy?

Laparoscopic cholecystectomy takes about an hour or two. A surgeon will make a few small incisions in your abdomen. The surgeon will insert thin, hollow tubes into those incisions. The surgical team will then place a laparoscope and other surgical tools into the tubes.

Your team may pump carbon dioxide into your abdomen. This step inflates the surgical area and makes it easier to see inside. Using the special tools, the surgeon will detach the gallbladder from the rest of the body and remove it. The team will then close the incisions with stitches, surgical clips or surgical glue.

If any complications occur during laparoscopic cholecystectomy, the surgeon may decide to use an open cholecystectomy instead. That procedure involves a larger incision.

What happens after laparoscopic cholecystectomy?

Your team will watch you for a few hours after surgery. They want to make sure you wake up from the anesthesia without complications. They will check your heart, breathing, blood pressure and ability to urinate (pee).

Removing the gallbladder will stop the pain and treat the infection caused by gallstones. It can also stop gallstones from coming back.

If gallstones are not treated, pain and infection can get worse. The gallbladder may burst, which can be life-threatening.

What are the benefits of laparoscopic cholecystectomy?

Your healthcare provider or surgeon will determine whether open or laparoscopic cholecystectomy is right for you. The laparoscopic procedure has several benefits:

• Less pain.
• Lower risk of complications.
• Quicker recovery and return to regular activities.
• Smaller wounds and scars.

What are the risks or possible complications of laparoscopic cholecystectomy?

Like any surgery, laparoscopic cholecystectomy has some risks, but they are rare:

• Bile leaking in the body.
• Bleeding.
• Complications from anesthesia.
• Hernia.
• Injury to the bile ducts, liver or intestines.
• Numbness in the surgical area.
• Peritonitis (inflammation and infection in the abdomen).
• Small scars from the incisions.
• Urinary tract infection.

If you don’t have any complications, you can usually go home the same day as your laparoscopic cholecystectomy. With an open cholecystectomy, you may have to stay in the hospital for a day or two.

What should I do to take care of myself after gallbladder removal?

After surgery, do the following to help yourself recover:

• Avoid lifting heavy things.
• Drink plenty of water.
• Eat foods high in fiber to help your bowel movements (pooping).
• Follow your healthcare provider’s instructions about taking care of your wounds and taking medications.
• Slowly increase your activity.
• Walk a little bit every day to prevent blood clots.

When can I go back to normal activities after laparoscopic cholecystectomy?

Without complications, you should be able to drive and eat normally in a day or two. You usually can return to work and other daily activities in about a week, as long as they don’t involve lifting. You may need a week or two before you are physically or sexually active.

After you go home, call your healthcare provider right away if you develop any of the following:

• Chills.
• Cramps in your abdomen or severe pain.
• High fever (over 101 degrees Fahrenheit).
• Incision problems, like bleeding, swelling, redness or a funny smell.
• No bowel movement for three days.
• Vomiting.
• Yellow skin.

A note from Cleveland Clinic

Gallstones can be very painful and dangerous. Laparoscopic cholecystectomy removes the gallbladder and prevents gallstones from coming back. Most people fully recover from the minimally invasive procedure in just a few weeks. But call your healthcare provider if you experience any problems after surgery.

Last reviewed by a Cleveland Clinic medical professional on 01/19/2021.

References

• American College of Surgeons. Cholecystectomy: Surgical Removal of the Gallbladder. (https://www.facs.org/~/media/files/education/patient%20ed/cholesys.ashx) Accessed 1/21/2021.
• National Institute of Diabetes and Digestive and Kidney Diseases. Gallstones. (https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones) Accessed 1/21/2021.
• Hassler KR, Collins JT, Philip K, Jones MW. [Updated 2020 Oct 1] Laparoscopic Cholecystectomy. (https://www.ncbi.nlm.nih.gov/books/NBK448145/) In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2020 Jan-. Accessed 1/21/2021.
• Society of American Gastrointestinal and Endoscopic Surgeons. What is Laparoscopic Gallbladder Removal Surgery (Laparoscopic Cholecystectomy)? (https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-gallbladder-removal-cholecystectomy-from-sages/) Accessed 1/21/2021.

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