Cholecystectomy (gallbladder removal surgery)

Cholecystectomy is surgery for gallbladder removal. This surgery may be necessary to provide pain relief from gallstones. It also may be needed to help other conditions gallstones may cause such as an inflamed gallbladder (acute cholecystitis), an inflamed pancreas (pancreatitis) or gallstones blocking the bile duct (choledoncholithiasis). Gallbladder surgery is one of the most common surgeries in the U.S.

What to expect during a cholecystectomy

If you require a cholecystectomy, you’ll drink a liquid to clean out your intestines in the days leading up to your surgery, and you’ll fast for about eight hours before surgery. Your doctor may tell you to stop taking certain medications. Once at the hospital, you’ll be given anesthesia through an IV, which will put you to sleep.

Laparoscopic cholecystectomy

A laparoscopic cholecystectomy is minimally invasive surgery to remove the gallbladder. During a laparoscopic cholecystectomy, the surgeon makes four small incisions in your abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. Your surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in your abdomen to remove your gallbladder. The surgery takes one to two hours.

After surgery your incisions will be sutured, and you’ll be taken to a recovery area. The anesthesia must wear off before you can be released from the hospital, and you’ll need someone to drive you home. It takes about a week to fully recover.

A laparoscopic cholecystectomy isn't appropriate for everyone. In some cases, your surgeon may begin with a laparoscopic approach, and then need to perform an open cholecystectomy if complications develop or they find scar tissue from previous operations.

Open cholecystectomy

During an open cholecystectomy, the surgeon makes a small incision in your abdomen below your ribs on your right side to allow for gallbladder removal. The procedure takes about one to two hours just like a laparoscopic cholecystectomy, but you’ll need spend two to three nights in the hospital, and it takes four to six weeks to fully recover. After either procedure, you might have some temporary diarrhea.

Gallbladder surgery recovery time

Recovery from laparoscopic gallbladder surgery takes about a week. Recovery from an open gallbladder surgery takes from four to six weeks.

Dietary recommendations after gallbladder removal

After having a cholecystectomy, your digestive system still functions. Your liver still makes bile so you can digest food. Instead of staying in your gallbladder, the bile drips directly into your digestive system.

Although your gallbladder is not essential, it helps you digest fatty foods. To avoid discomfort after gallbladder removal, fat calories should make up no more than 30% of your diet. In the weeks after surgery, reintroduce high-fiber foods slowly. Whole grains, nuts, seeds and vegetables may cause severe bloating or gas if you eat too much too quickly.

Cholecystectomy risks

Your risk of complications depends on your overall health and the reason for your cholecystectomy. A cholecystectomy generally has a small risk of complications including damage to the bile duct, liver and small intestine ducts. This damage can cause leakage or obstruction of bile flow and lead to abdominal pain, fever and yellowing of skin, known as jaundice. These symptoms can also be caused by a gallstone that is left behind in the bile duct.

Bleeding from a blood vessel near the gallbladder can sometimes occur. Most bleeding stops on its own, but rarely, persistent bleeding requires intervention. Infection is also possible. If you experience worsening pain, fever, chills, nausea, vomiting or jaundice after gallbladder removal, you should see a doctor.

Reasons for cholecystectomy

Changes in diet, hormones, medications or rapid changes in weight can result in formation of small, pebble-like substances called gallstones inside the gallbladder, a pear-shaped organ below the liver. Gallstones are the most common reason for gallbladder removal surgery. In the U.S., more than 6 million men and 14 million women have gallstones, with higher rates in Native Americans and Hispanics.

Gallstones develop when bile contains too much cholesterol or salt and becomes solid. They can become a problem when they migrate outside the gallbladder and block the flow of bile, leading to inflammation and infection of the gallbladder. This is called acute cholecystitis, which can cause sharp, constant abdominal pain, fever, nausea and vomiting. Visit your physician if you're having these symptoms. The doctor can order an ultrasound and find out if you need to get a cholecystectomy.

Gallstone symptoms

Some people have gallstones but never feel any discomfort or develop any signs. See your doctor right away if you have these symptoms. They may be signs of a serious infection or inflammation of the gallbladder, liver or pancreas.

• Abdominal pain lasting several hours
• Nausea and vomiting
• Fever or chills
• Jaundice
• Tea-colored urine
• Light-colored stools

Gallstone risks and prevention

The following factors can increase your risk of developing gallstones:

• Higher concentration of cholesterol or bilirubin in bile
• Hormones or medications that decrease the emptying of the gallbladder
• Obesity
• Inactive lifestyle
• Being female
• Being over age 40
• Diabetes
• Liver disease
• Family history of gallstones
• Consuming large amounts of saturated fat, trans fatty acids and refined sugar

To prevent gallstones, your doctor might suggest reducing fat and sugar in your diet and taking supplements such as vitamin C, soy, lecithin and iron, which could prevent stones from forming. It’s also important to maintain a healthy weight and stay active to help prevent gallstones.