Open gallbladder removal—or cholecystectomy—is surgery that offers permanent relief to a patient suffering from gallstones and other problems associated with the gallbladder.
The gallbladder is a small organ located near the liver. It stores bile—which is a special fluid produced in the liver. Your gallbladder releases the bile into your small intestine in order to break down fats and help digest your food.
However, normal digestion is possible without a gallbladder. Bile will continue to reach your small intestine it just won’t be stored along the way in the gallbladder and the removal of a gallbladder rarely causes problems.
According to the Mayo Clinic, laparoscopic removal is the most common type of gallbladder removal surgery. (Mayo) However, open gallbladder surgeries are still used for a variety of patients—especially those who have scar tissue or other problems from prior surgeries.
A surgeon will remove your gallbladder if gallstones cause pain and other complications. Gallstones are hard deposits of substances in the bile that get stuck inside the gallbladder. They range in size from grains of sand to golf balls. This condition—called cholelithiasis —can cause short or lasting pains in the abdomen.
Other conditions that could make you a candidate for open gallbladder removal include:
- biliary dyskinesia: the gallbladder does not fill or empty correctly due to a defect
- choledocholithiasis: gallstones have moved to the bile duct and may be causing blockage that do not allow the gallbladder to drain
- cholecystitis: inflammation of the gallbladder
- pancreatitis: inflammation of the pancreas
Laparoscopic surgery is preferred over traditional open surgery because it is less invasive and has a shorter recovery time. However, certain complications can make open surgery a better choice.
Sometimes, a surgeon will begin using the laparoscopic method, but will not be able to safely remove the gallbladder. In this case, he or she will finish the procedure in the open fashion.
Open gallbladder removal is considered a safe operation and complications are rare. However, every surgical procedure carries some risks. Before the procedure, your doctor will perform a complete physical examination and medical history to minimize these risks.
Risks of open gallbladder removal include:
- allergic reaction to anesthesia or other drugs
- blood clots
- damage to blood vessels
- heart problems (such as rapid heart rate)
- injury to the bile duct or small intestine
- pancreatitis, or inflammation of the pancreas
Prior to surgery, you’ll undergo several tests to ensure you are healthy enough for the procedure. These will include blood tests, imaging tests of your gallbladder, a complete physical, and a complete medical history.
During these appointments, tell your doctor if you are taking any medications—including over-the-counter drugs or nutritional supplements. Certain medications can interfere with the procedure, and you may have to stop taking them prior to surgery. Also tell your doctor if you are pregnant or may be pregnant. (SAGES)
Your doctor will give you complete instructions on how best to prepare for surgery. These may include:
- arranging to have someone drive you home and stay with you immediately after surgery
- drinking a prescription solution that flushes out your bowels
- fasting (not eating or drinking) for four hours or more before surgery
- planning for a hospital stay in case of complications
- showering using a special, antibacterial soap
Prior to the procedure, you’ll change into a hospital gown and will be given an IV so your doctor can deliver medications and fluids directly into your bloodstream. You will also be given general anesthesia, so you’ll be in a painless sleep before the surgery begins.
Your surgeon will access your gallbladder through a six-inch incision on the right side of your abdomen, just below your ribs. The skin, muscle, and other tissues are pulled back to expose your gallbladder. Your surgeon then removes your gallbladder, closes the wound with sutures (or stitches), and bandages the area.
After your surgery, you will be wheeled back to your hospital room. Your vital signs will continue to be monitored until you are released home.
You may experience some mild diarrhea after the gallbladder removal surgery. However, this is rare.
Typically, you should expect to spend up to three days in the hospital while you begin to recover. A full recovery from open gallbladder surgery takes about four to six weeks.
You will be encouraged to walk around as soon as you start feeling better. Your doctor will instruct you on when you’ll be ready to resume your normal activities.
While you recover, you’ll need to care for your incision wounds. This includes washing them properly. Most people are able to shower the day after surgery. Your doctor will provide more instructions and remove the stitches during a follow-up appointment.