Gallbladder Surgery or Cholecystectomy
Gallbladder surgery, also known as cholecystectomy, involves the removal of the gallbladder from the body. It is one of the most common general surgery procedures performed in the United States and represents a simple, curative option for various forms of gallbladder disease – most commonly symptomatic gallstones.
How a Cholecystectomy Works
Gallbladder surgery is almost always performed in a minimally invasive manner. This means that four or five small incisions are made in the abdomen versus a large single incision in open surgery.
Once the patient is prepped for surgery, they will be put under general anesthesia for the procedure. Four or five small incisions are made in the abdomen, the largest of which is made in the umbilicus or belly button. Specially made laparoscopic tools including a high definition camera allows Dr. Shawn Tsuda or Dr. Heidi Ryan to carefully separate the gallbladder from the liver. The blood and bile duct vessels coming from the gallbladder are then clamped with permanent titanium clips.
Once the vessels are clamped and sealed, the gallbladder is separated from its associated structures, placed in a surgical bag, and removed through the incision in the bellybutton.
In rare cases, the procedure may have to be converted to open surgery for the safety of the patient. This risk is increased if you have had previous surgery in the area and lots of scar tissue formed. This and other risks will be discussed during your consultation
The entire gallbladder removal procedure takes about 35-to-45 minutes and is performed on an outpatient basis, meaning that patients can return home the day of surgery.
The gallbladder is then sent off to pathology to ensure that there is no trace of cancer or other abnormalities of the organ. This involves cutting the gallbladder open and examining the color and texture of both the gallbladder itself and the gallstones. Gallbladder cancer is a very rare but aggressive form of cancer and it is always prudent to rule it out. Having gallstones is not a risk factor for gallbladder cancer, however extremely large gallstones may increase the relative risk of cancer very slightly. Overall risk still remains very low.
Recovery and Aftercare
After surgery, you will be transferred to the recovery area where you will wake up from general anesthesia. The entire recovery process takes about two to three hours. Once you can ambulate and urinate, you are typically discharged with post-op instructions.
Once home, dietary and exercise restrictions are minimal. Most patients describe the recovery process as uncomfortable rather than painful. You will likely not require any narcotic pain medication and will be fine with acetaminophen to blunt any discomfort.
You may experience some constipation due to the general anesthesia and any narcotic pain medication you may be taking. You will be encouraged to start walking right away, within the bounds of your abilities to minimize the potential for blood clots or deep vein thrombosis. At around two weeks, you will follow up with your surgeon to evaluate the recovery process.
Will I gain weight after a gallbladder removal?
One of the common misconceptions that you may read online is that you will gain weight due to the gallbladder removal surgery. There is no support to the theory that the surgery itself causes any weight gain. More than likely, you will have been avoiding many fatty and high sugar foods because they would have triggered a gallstone attack prior to surgery. With a more liberal diet and no self-limiting attacks to stop you, there is the potential to start eating less healthy foods and ultimately gain weight after surgery. However, with a good postoperative diet and exercise regimen, weight gain should not be an issue.
Will I have gastrointestinal issues after my gallbladder removal?
You may. First, it will take some time for the liver to start producing enough bile to properly metabolize the fat that you consume during your meals. Even after this time, if you consume too much fat, you may experience some gastrointestinal upset or diarrhea. Any G.I. issues will improve over time. If you experience constipation in the few days after surgery, this may be due to the general anesthesia or due to the narcotic pain medication, if any, that you may be taking.
Good to Know Summary
- Only symptomatic gallstones require surgery. Most people with gallstones remain asymptomatic
- While it is major surgery, gallbladder removal is one of the most common and safest surgical procedures
- Being female, overweight, around 40 years of age and fertile are the biggest risk factors for a gallstone attack
- You will not gain weight due to the removal of your gallbladder alone