Cholecystectomy: Risks, Preparation, Procedure, Cost, Recovery

A cholecystectomy refers to the surgical procedure used to remove the gallbladder. The gallbladder is the organ located on the upper right side of the abdomen, just below the liver. The gallbladder is the body part, which collects and stores bile. Bile is the fluid produced by the liver to aid in digestion. Gallbladder removal surgery is common. It is not a serious procedure. Your surgeon performs the surgery using a special camera and surgical tools. Using incisions, your doctor removes the gallbladder. In some cases, the surgeon just makes a big incision and removes the organ without using a camera. The surgery carries only a small margin of risk and has little or no complication. In most cases, people undergoing surgery can leave the hospital the next day of the surgery. Read ahead to know more about the surgery and get information to handle it better.

About Gallbladder

Before learning about the surgery to remove the organ, you need to know about the organ itself. The gallbladder is the small organ present in your upper abdomen. Your abdominal region consists of many important organs like stomach, gallbladder, etc. The middle region in your body is known as the abdominal area. The gallbladder looks like a small pouch. It sits under your liver. The digestive fluid called bile is produced by your liver. It is stored in your gallbladder. Generally, the gallbladder looks like the size of the pear before your meal. It is because the gallbladder is filled with bile. After meals, the gallbladder becomes empty. So, it looks like a deflated balloon.

Function Of Gallbladder

The main function of the gallbladder is to collect and store bile. Bile is the digestive fluid that helps your body break down food during digestion. As time progresses, small, hard deposits can form in your gallbladder. These deposits are referred to as gallstones. Most people around the world can develop gallstone as it is a common condition. In some cases, these stones can trigger different health problems. When you consult from the doctor, they can suggest surgery to remove it. The majority of the people undergo gallbladder removal surgery when the organ no longer works correctly and trigger pain. It also causes other symptoms like:

• Sharp abdominal pain
• Nausea
• Vomiting
• Fever
• Indigestion
• Jaundice (skin or white of eyes turn yellow)

Need For Cholecystectomy

Cholecystectomy is usually suggested by the doctor to treat conditions triggered by a gallstone. Gallstones can cause different complications. To manage the complications caused by the problem, your doctor may decide to remove the gallbladder from the body. The different circumstances leading to gallbladder removal are:

Presence Of Gallstones

Cholelithiasis

The condition referred to as cholelithiasis can trigger pain, nausea or result in gallbladder inflammation. It occurs when the substances in your bile crystallize in the gallbladder. It leads to the development of gallstones. In most cases, the condition may cause no harm. But, when you experience adverse symptoms, you need surgery to remove the organ and manage the problem.

Infection Of Gallbladder

Also known as cholecystitis, the condition develops due to the presence of gallstones in the gallbladder. You can develop, fever and pain when you suffer from the condition. Your doctor suggests surgery to remove the gallbladder when the infection continues for a long time or recurs.

Gallbladder Cancer

The presence of cancerous cells in your gallbladder needs surgery to remove the organ. While cancer may not affect your gallbladder in the majority of the cases, it can happen. It is difficult to diagnose the problem in its early stages. So, you become aware of the problem only at a later stage when several symptoms appear. The symptoms can mimic those of gallstones.

Choledocholithiasis

It is the condition causing the gallstones in the bile duct. It is also referred to as bile duct stones. In normal cases, the gallstones form in your gallbladder. The bile duct is the tube that carries bile from your gallbladder to the intestine during digestion. Most of the time, these stones remain in the gallbladder. But, some of them can pass through the bile duct unobstructed. Such stones can trigger several issues and need invasive surgery to remove the organ.

Large Gallbladder Polyps

Gallbladder polyp refers to small, abnormal growth of tissue. It has a stalk protruding from the gallbladder lining. When they become large in size, the chances of cancerous presence increases. It can affect your health.

Pancreatitis Due To Gallstones

The gallstones can block your pancreatic duct. The condition can cause inflammation of your pancreas. It can trigger severe symptoms. You can experience fever, chills, nausea, abdominal pain, vomiting, or jaundice due to the problem. The condition requires immediate medical assistance. Without treatment, gallstone pancreatitis can cause severe complications.

Types Of Cholecystectomy

You have two types of gallbladder surgery available. The two surgery options available for people suffering from issues due to gallbladder problems are:

Open Cholecystectomy

A large incision made in your abdomen ads in gallbladder removal. This method is known as an open cholecystectomy. The incision, about six inches is large enough to remove the organ. Your surgeon opts for the treatment when cancerous presence is suspected. Extended open surgery removes cancerous cells from the gallbladder.

Laparoscopic Cholecystectomy

As the name suggests, it involves removing the gallbladder using laparoscopic surgery. The surgeon makes small cuts or incisions in the belly. Through the incision, the doctor places a laparoscope (light and camera at one end). It aids in gallbladder removal. But, it is not the right option when your doctor suspects or detects cancer.

Risks Associated With Cholecystectomy

Removing gallbladder using surgery is not free of any risks. The risks you can develop depends on your overall health, type of procedure you select, and the underlying reason for undergoing the procedure. The risks associated with the different procedures are:

Risks With Open Technique

When your surgeon suggests an open technique to remove the gallbladder, it indicates an untypical situation. So, the risks associated with the technique is higher compared to the routine laparoscopic gallbladder removal procedure. The risks increases because the surgeon makes a larger incision. So, it increases your risk of developing the following:

• Wound infection
• Hernia formation
• More pain
• Hematoma
• Bile duct injury to nearby structures (small intestine, liver, bile duct)
• Bile leaks
• Retained bile duct stones
• Risk due to general anesthesia (pneumonia or blood clots)

Risks With Laparoscopic Cholecystectomy

While the laparoscopic method to remove a gallbladder has low risks compared to open procedures, complications can arise. The risks arise when the surgery is performed by an inexperienced surgeon. So, the problem that can arise are:

• Bile duct injury
• Bowel injury
• Bile leaks

The minimally invasive approach is comparatively safe. But, the problem you face depends on the surgeon as well as technical constraints.

Cost Of Cholecystectomy

The cost of the laparoscopic procedure ranges from $6000 to $12,000 while open procedure costs around $1000 to $1500.

Prepare For Cholecystectomy

You need to prepare yourself before the surgery. Your surgeon provides you with a list of guidelines. Make sure you follow the suggested instructions. The list may include the following:

Food And Medications

You have to take care of what you eat and drink before the surgery. Try not to eat anything the previous night before the surgery. You can take a sip of water. It is allowed for people who take medications. Avoid food or drinks at least four hours before your cholecystectomy.

Stop taking medications or any other supplements. You need to tell your doctor about the list of medications as well as supplements you take. If the doctor allows, you can take most of the medications prescribed. But, you need to stop medication containing aspirin. It increases your risk of bleeding. So, you need to avoid medication and supplements with aspirin.

Clothing And Personal Items

While people can go home the same day after their gallbladder removal surgery, your doctor makes you stay in the hospital overnight. It is to monitor for any complication occurs due to the surgery. Some people can develop complications during surgery. So, you need to extend your stay in the hospital for one or two days. So, you need to prepare yourself for staying in the hospital. Plan ahead by bringing comfortable clothes, personal items like toothbrushes, and other items needed to make your stay less boring.

Other Precautions

You need to take it easy for a few days after the surgery. So, you need someone with you to assist with things. Ask your friend or relative to stay with you and drive you home. You need someone to give you company in the hospital.

What To Expect With Cholecystectomy?

Undergoing an invasive procedure irrespective of how small it is can make you antsy. But, knowing more about the procedure in detail helps you prepare. It can make your mind feel comfortable about dealing with the procedure. Here is what you can expect before, during, and after cholecystectomy.

Before Cholecystectomy Procedure

Before performing the procedure, your doctor uses general anesthesia. So, you are unconscious during the procedure. To give anesthesia, medications, and fluids, you are hooked to an IV. The drugs are usually given through the vein in your arm. After some time of giving the drugs, it starts taking effect. The healthcare team inserts a tube down the throat. It is to help you breathe properly during the procedure. Then, your surgeon starts the procedure using an open technique or laparoscopically.

During Cholecystectomy Procedure

You have two types of procedure to remove gallbladder, open procedure or laparoscopic. Depending on the type, the procedure of surgery varies.

Laparoscopic Cholecystectomy

It is the minimally invasive method with fewer complications and a faster healing period. During the procedure, your surgeon makes four incisions on your abdomen. The small incision help insert a tube with a camera at one end into your abdomen region. Your surgeon watches the video monitor that shows images of your abdominal region captured by the camera. Using the other incisions, the surgeon inserts surgical tools to remove the gallbladder. After removing the organ, you need to undergo imaging tests like ultrasound or x-ray. It is to detect the presence of gallstones or other complications in your bile duct. After ruling out such a problem, the surgeon closes the incision with sutures.

You get transferred to the recovery area to monitor any complications. The whole procedure takes one to two hours. The procedure is not suitable for everyone. People experiencing scar tissue from prior operations or complications cannot undergo a minimally invasive procedure. In such cases, larger incisions are required to remove the gallbladder.

Open Cholecystectomy

The open procedure is the traditional method to remove the gallbladder. During the procedure, your surgeon makes a big incision on your abdomen (six inches or fifteen centimeters). The incision on your abdomen just below the ribs on your side gives access to the abdominal region containing gallbladder. The surgeon pulls the muscles and tissues to reveal the liver and gallbladder. Then, the surgeon removes the gallbladder and sutures the incision. You have to stay in the recovery area for monitoring. The procedure takes one or two hours to complete.

After Cholecystectomy Procedure

You have to spend some time in the recovery area after the procedure. It is to wear off the effects of anesthesia. You continue to recover in a hospital room. The recovery period depends on the type of procedure:

Laparoscopic Cholecystectomy

You can go back to your home the next day after the surgery. An overnight stay is suggested by the surgeon to rule out any complications. Once you start eating and drinking without any pain, you can go home. The surgeon also checks your pain level while you walk or move before discharging from the hospital. You need at least a week to recover from the procedure.

Open cholecystectomy

The type of procedure takes a longer time to heal. You have to spend two to three days in the hospital. You can go home after the doctor checks your pain levels and the ability to walk without aid. But, to recover completely, you need at least four to six weeks.

Recovery Process After Cholecystectomy

You have to follow the guidelines offered by the doctor after the surgery to ensure good healing. The surgeon gives you a list of pointers to follow at home. Recovering from the procedure takes six weeks or more based on the type of procedure you undergo. You have to remain patient for several weeks and slowly return to your normal routine. Therefore, you need to follow the suggestion provided below while you recover from the procedure:

Take Pain Medication

You can experience pain in your belly for a few days. You can also experience shoulder pain as a result of the surgery. It occurs in one or both of your shoulders. The pain occurs due to the gas left behind in your stomach after the surgery. The pain eases over several days. You need to take the medications provided by the doctor to manage pain and discomfort.

Other Medications

As a result of the procedure, you can expect some discomfort. So, your doctor suggests medications to deal with such problems as:

• You can experience a sore throat as a result of inserting a breathing tube. It can cause discomfort for one or two days. So, taking throat lozenges can soothe the sore throat.
• People can feel nauseous and tend to throw up after the procedure. So, you need to take nausea medication as suggested by your doctor.
• In some cases, people can see loose stools after eating food. It can last for four to six weeks or longer. Talk to your doctor to deal with the problem.
• You can see bruising around the wounds. It requires no specific treatment as it goes away on its own. The skin redness around the wound heals as time progress. It is a normal occurrence. Therefore, you never have to panic.

Ease Into Activity

You need to start walking immediately after the surgery. As soon as you feel up for it, begin your everyday activities. You need to move around your house and use stairs within the first week. Take shower and not a bath until the incision heals. If it hurts when you do something, then stop the activity immediately. Refrain from driving for a week and avoid lifting heavy objects. Strenuous activities can put pressure on your abdominal region. So, any time you indulge in activities triggering pain or pulls your stitches, then stop it.

People can get back to their work based on their pain level and overall health condition. If you feel energetic to complete the tasks, then you can start your work. Before starting your work, talk to your doctor. The doctor needs to give you an all-clear before getting back to physical work.

Wound Care

To ensure good wound healing, you need to take care while showering. Take off the wound dressing covering your sutures, glue, or staples before showering. If your doctor has used tape strips to cover your incisions, then you need to protect it from water. So, cover the wounds with plastic wrap before showering. Never wash tape strips as they need to fall off on their own. Avoid soaking in a bathtub or hot tub until your wound heals. You need to get ok from your doctor before going for a swim.

Check Your Diet

You have to eat a fiber-rich diet. It is to prevent constipation that puts extra pressure on your bowels and abdomen. Also, drink 8 to 10 glasses of water to ease bowel movements. Avoid spicy or greasy foods for a while to prevent bowel irritation.

Follow-Up Appointment

You need to schedule a follow-up appointment with your surgeon to assess the wound healing one or two weeks after the surgery.

Emergency Symptoms

You need to monitor for the following signs that indicate some serious problem:

• You have a temperature above 101 degrees Fahrenheit (38.3°C).
• The surgical wounds bleed
• Pus drainage that is thick, green or yellow
• Wound site looks red
• Severe pain that is not alleviated with pain medications
• Trouble breathing properly
• Persistent coughing
• Trouble eating or drinking
• Skin or white of eye turns yellow
• Stools look grey

The above-mentioned signs indicate some serious infection or complication, which requires immediate medical attention.

Results Of Cholecystectomy

You get relief from pain triggered due to gallstone after undergoing the procedure. When dietary modifications and other conservative treatments fail to offer results, then your doctor suggests removing gallbladder to prevent the recurrence of gallstone. Cholecystectomy can prevent gallstones from coming back. The majority of people undergoing the procedure may not experience a digestive problem. It is because the gallbladder is not essential for healthy digestion. But, very few people can see loose stool after the procedure. The issue resolves over time. You need to talk to your doctor regarding the new symptoms or any bowel changes after the procedure.

Conclusion

Cholecystectomy is a simple and common procedure. Depending on the type of procedure and overall health, you can take a few days to weeks to get back to normal activities. You can recover from the procedure without any complications. Follow the instruction provided by your medical team and take good care to ensure a speedy recovery.

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