Gallbladder removal

What is the gallbladder?

The gallbladder is a pear-shaped organ beneath the liver, where bile (a dark green to yellowish brown fluid produced by the liver) is stored and concentrated before it is released into the small intestine. The gallbladder is not absolutely necessary for human survival, as bile can reach the small intestine in other ways.

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When is cholecystectomy (gallbladder removal) necessary?

A cholecystectomy is most commonly performed to treat gallstones – small and hard stones, formed within the gallbladder or the bile duct out of bile components such as cholesterol, bile salts and bilirubin. Gallstones made up mainly of cholesterol are termed ’cholesterol stones’, and those mainly from bilirubin are termed ’pigment stones’. 80% of gallstones do not cause symptoms and go unnoticed, but sometimes stones may block the flow of bile out of the gallbladder, causing inflammation and swelling, resulting in sharp abdominal pain, vomiting, indigestion and, occasionally fever or jaundice. This is called a gallbladder attack.

In those who are having gallbladder attacks, surgery to remove the gallbladder is typically recommended. This is a long-established and safe way of treating gallstones. The operation can be carried out either through several small incisions or through a single larger incision, usually under general anesthesia. Alternative treatments (medication) to break up or dissolve gallstones are largely unsuccessful.

How is the surgery performed?

The most common surgical method used to remove the gallbladder is known as cholecystectomy.

The technique involves the insertion of a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder. It is called laparoscopic cholecystectomy and requires only a short stay in hospital.

What are the risks and benefits of the operation?

Cholecystectomy can immediately relieve the pain and discomfort caused by gallstones. Furthermore, the recurrence of gallstones cannot usually be prevented by conservative treatment methods, such as dietary modifications.

As with any surgery, there are some risks associated with cholecystectomy, including infections, bleeding, blood clots and bile leak.

Some people may experience mild diarrhea after having their gallbladder removed, though it is usually only temporary. Most people however won’t experience any digestive problems as the presence of the gallbladder is not essential to a healthy digestion. Individual risk factors may vary depending on the reason for the surgery and the patient’s overall health.

You will receive a patient information sheet and an informed consent form which will provide you with detailed information regarding the risks of the operation, as well as what to expect before, during and after the procedure. By all means feel free to discuss the possible risks or any other concerns with your surgeon before making a treatment decision.

There are certain risks associated with general anesthesia too, these will be explained to you on a separate information sheet. You will be required to sign a second informed consent form regarding anesthesia. You will also have some preoperative tests to ensure that these risks are reduced to a minimum.

Am I a good candidate for cholecystectomy?

Although there are many advantages to laparoscopic gallbladder removal, the procedure may not be appropriate for some patients who suffer from more complicated gallbladder diseases or have previously had upper abdominal surgery.

Your doctor will decide if surgery is necessary in your particular case.

You will be asked to undergo some tests (blood and allergy tests, chest X-ray, ECG), and to see your anesthesiologist and internist before your operation. This is to ensure that your general health and physical condition allow a cholecystectomy under general anesthesia to be carried out safely.

All of our patients are asked to complete a detailed medical history form. It is important to fill out the questionnaire to the best of your knowledge because the answers you provide will help our surgeon decide whether you are eligible for this type of operation.

How to prepare for the surgery?

Prepare a list of all of your symptoms and any known medical conditions, past illnesses and allergies, even if they seem unrelated to your current condition. For this purpose, you will be given a detailed form to be filled out, followed by a physical examination.

Be aware of any restrictions to adhere to prior to procedure such as dietary restrictions for the day before the operation. You might be asked to stop taking certain medications and to drink a solution which will help clean your bowels for the surgery. Your surgeon will provide you with all the necessary information regarding preparation for the diagnostic tests and the operation itself.

List all the drugs and medications you take, including vitamins and supplements.

Ask a family member or friend to accompany you to your appointment and aks them to help you recall the information to be provided during the consultation.

Before making a treatment decision you will receive a patient information sheet and an informed consent form which you will be requested to read carefully and sign. These documents will contain everything you need to know regarding preparation, the surgery itself and recovery.

Cholecystectomy is performed under general anesthesia, so you won’t be awake during the procedure.

What to expect after the surgery?

After your surgery you will be required to stay in Medicover Hospital for one night. Patients usually experience minimal post-operative pain which can be managed – if necessary – with over the counter pain medication. You can expect that be able to return to a normal diet immediately and to walk unaided. You can return to work a couple of days after the procedure. It takes about a week to fully recover. Some people may experience some bloating and loose stools from time to time, but these problems usually resolve on their own within a few weeks.

Why is follow-up important?

A follow-up appointment will be scheduled for about 7-10 days after the surgery for stitches removal. This appointment will also allow your doctor to monitor your recovery.