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Gallbladder removal

Key points

You may need to have your gallbladder removed if you have gallstones or gallbladder cancer.The operation to remove your gallbladder is called cholecystectomy. It’s usually done using keyholesurgery.Some of the side-effects of gallbladder removal are pain and discomfort, bloating and diarrhoea.Most people can digest food and drink normally without a gallbladder.

Featured FAQ

Will having my gallbladder removed affect how I can digest my food?

Most people can digest food and drink normally without a gallbladder. However, around one in 10 people getdiarrhoea after the operation. You can help yourself by making some changes to your diet.

See all our FAQs on gallbladder removal (/individuals/health-information/directory/g/gallbladder-removal?tab=faqs)

Information (?tab=Information)

Your gallbladder collects and stores liquid called bile, which helps your body to digest food. Your gallbladdermay need to be removed if it becomes diseased or damaged, or if you have gallstones (/individuals/health-

information/directory/g/gallstones) .

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is describedhere as it will be designed to meet your individual needs.

About gallbladder removal

Your gallbladder is a small pouch connected to your liver and your intestines by tubes called bile ducts. Itcollects and stores liquid called bile. Bile contains chemicals that help you to digest the fat in your food. Bilealso helps your body to use some vitamins, such as vitamin A, D and E. Bile passes from your gallbladder intoyour intestine and is released from your gallbladder when you eat.

Gallstones are lumpsof solid material thatdevelop from thechemicals andsubstances in bile.They vary in size andcan take years todevelop. Sometimesthey become largeand can block yourbile duct, or thesmaller ones maytravel through the bileduct and block theopening to yourpancreas causing aserious conditioncalled pancreatitis(/individuals/health-

information/directory/p/pancreatitis) or ‘inflammation of the pancreas’.

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You may need your gallbladder removed if you have gallstones and they are:

causing pain and inflammationcausing jaundice (your skin and the whites of your eyes will become yellow)blocking the opening to your pancreas and causing pancreatitis

If you have gallbladder cancer (/individuals/health-information/directory/g/gallbladder-cancer) you may also need tohave your gallbladder removed.

There are two main surgical techniques used to remove the gallbladder.

Laparoscopic cholecystectomy – your gallbladder is removed through small puncture holes in yourabdomen (tummy), using the surgical technique of keyhole surgery.Open cholecystectomy – your gallbladder is removed through one large cut in your abdomen, using asurgical technique called open surgery.

Animation - how gallbladder removal surgery is carried out

What are the alternatives?

There are a number of alternative treatments for gallstones. The main ones are listed below.

You can manage your symptoms using painkillers and other medicines and see if the problem gets anyworse. This is called watchful waiting. Your GP will monitor your condition and he or she may suggestfurther treatment if your symptoms get worse.If gallstones are in your bile duct they can be removed during ERCP. ERCP is a test that can be used todiagnose gallstones, and if they are found during the procedure they can sometimes be removed.Gallstones can be broken up using shock waves. This is called extracorporeal shockwave lithotripsy(ESWL). A special probe uses high energy sound waves to break up the stones. This treatment is nowrarely used.

If you have gallbladder cancer you may have treatment using radiotherapy and/or chemotherapy instead ofsurgery.

Your surgeon will discuss any possible alternative treatments with you.

Preparing for gallbladder removal

Your surgeon will explain how to prepare for your gallbladder removal. For example, if you smoke, you will beasked to stop as smoking increases your risk of getting a chest and wound infection, which can slow yourrecovery.

Gallbladder removal using keyhole surgery is usually done as a day-case procedure, but you may need to stayovernight in hospital. Gallbladder surgery is usually done under general anaesthesia (/individuals/health-

information/directory/g/anaesthesia) . This means you will be asleep during the operation.

If you're having general anaesthetic, you will be asked to follow fasting instructions. This means not eating ordrinking, typically for about six hours beforehand. However, it's important to follow your surgeon's advice.

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Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain youmight have. This is your opportunity to understand what will happen, and you can help yourself by preparingquestions to ask about the risks, benefits and any alternatives to the procedure. This will help you to beinformed, so you can give your consent for the procedure to go ahead, which you may be asked to do so bysigning a consent form.

You may be asked to wear compression stockings (/individuals/health-information/directory/c/compression-

stockings) to help prevent blood clots forming in the veins in your legs. You may need to have an injection of ananticlotting medicine called heparin as well as, or instead of, wearing compression stockings.

What happens during gallbladder removal?

A gallbladder removal operation is usually done as keyhole surgery. Your surgeon will make small cuts in yourabdomen. He or she will gently inflate your abdomen using carbon dioxide gas to create space and to make iteasier to see. Your surgeon will pass a laparoscope (a long, thin telescope with a light and camera lens at thetip) through one of the cuts, so that he or she can see your internal organs on a television screen.

At the end of the operation, the carbon dioxide gas is allowed to escape and the instruments are removed. Yoursurgeon will close the wounds with stitches or metal clips and cover them with a dressing.

Sometimes it isn’t possible to remove your gallbladder using keyhole surgery and your surgeon may do an opencholecystectomy instead. This is where your surgeon makes one larger cut in your abdomen to remove yourgallbladder.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with anydiscomfort as the anaesthetic wears off.

If you have keyhole surgery you may have some discomfort and bloating caused by the carbon dioxide gas putinto your abdomen during the operation. This can also cause pain in your shoulder. This usually eases within 48hours after your operation.

If you have had your operation as a day-case, you will usually be able to go home when you feel ready. You willneed to arrange for someone to drive you home. Try to have a friend or relative with you for the first 24 hoursafter your surgery.

Before you go home your nurse will give you some advice about caring for your healing wounds. You may alsobe given antibiotic tablets to take to prevent an infection. You may be given a date for a follow-up appointment.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drinkalcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving,contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon'sadvice.

If your wounds are closed with metal clips or stitches, these will be removed by a nurse after about a week.Commonly, dissolvable stitches are used with this procedure. The length of time your dissolvable stitches willtake to disappear depends on what type you have.

Recovering from gallbladder surgery

It usually takes two to three weeks to make a full recovery from keyhole surgery to remove your gallbladder, butthis varies between individuals, so it's important to follow your surgeon's advice.

If you have an open operation with a large cut to your abdomen, your recovery will take longer. It may take fourto six weeks for you to make a full recovery.

If you need pain relief, you can take over-the-counter painkillers (/individuals/health-information/directory/o/over-the-

counter-painkillers) such as paracetamol or ibuprofen. Always read the patient information leaflet that comeswith your medicine and if you have any questions, ask your pharmacist for advice.

Following keyhole surgery you may be advised not to drive for two weeks after your operation. Ask your surgeonfor more information.

What are the risks?

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As with every procedure, there are some risks associated with gallbladder removal. We have not included thechance of these happening as they are specific to you and differ for every person. Ask your surgeon to explainhow these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

Possible side-effects may include:

shoulder painabdominal painbloating and abdominal discomfortdiarrhoeaflatulence (wind passed from your back passage)indigestion

If your skin or the white of your eyes become yellow, or if you develop a high temperature or a severe pain thatgets worse, you should contact your GP straight away or go to the Accident and Emergency department.

Complications

Complications are when problems occur during or after the procedure. The possible complications of anyprocedure include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot,usually in a vein in the leg (deep vein thrombosis, DVT).

During the operation your surgeon may need to convert from a keyhole procedure to open surgery. He or shewill need to make a bigger cut in your abdomen. This will only be done if it’s not possible to complete youroperation safely using the keyhole technique. Other possible complications may include:

accidental damage to your bile duct or other organsinfectionleakage of bile from your bile duct

For answers to frequently asked questions on this topic, see FAQs (/individuals/health-

information/directory/g/gallbladder-removal?tab=FAQs) .

For sources and links to further information, see Resources (/individuals/health-information/directory/g/gallbladder-

removal?tab=Resources) .

Produced by Dylan Merkett, Bupa Health Information Team, March 2013.

Find out more about our health editors (/individuals/health-information/profiles)

This information was published by Bupa's Health Information Team and is based on reputable sources ofmedical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only forillustrative purposes and do not reflect every presentation of a condition. The content is intended only for generalinformation and does not replace the need for personal advice from a qualified health professional. For moredetails on how we produce our content and its sources, visit the about our health information (/individuals/health-

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