How to Prepare for Gallbladder Surgery

Laparoscopic gallbladder removal is one of the most commonly undertaken surgeries. 

The Gallbladder

• It is pear-shaped and located under the liver, in the upper right section of your abdomen. 
• Its primary function is to store bile formed in the liver. When you eat, the bile is excreted to the small intestine through the bile ducts.
• Gallbladder removal is not a result of digestion problems in patients.

Causes of Gallbladder Problems

• Gallbladder complications are mainly caused by gallstones. Gallstones are a result of substances found in bile.
• Older adults aged 40 and above, pregnant women, and people from families with a history of gallstones are more at risk of developing them.
• It is nearly impossible to prevent gallstones from forming.
• Gallstones block the bile ducts. This always results in severe abdominal pain. In some cases, patients experience nausea, vomiting, and fever.
• The skin might turn yellow when the bile ducts are blocked.

How Gallbladder Problems are Detected and Treated

• The most common way to identify gallstones is through the help of an ultrasound.
• Sometimes, x-rays and nuclear scans are performed to check gallbladder infections.
• Gallstones normally do not go away on their own, although sometimes they don't cause symptoms. 
• The most recommended and safest way to remove gallstones is through surgery.

The Advantages of Undergoing Laparoscopic Gallbladder Removal (Over Open Gallbladder Surgery)

• The surgery always requires only four small cuttings in the abdomen.
• After the surgery, the patient experiences very little pain.
• Unlike in open surgeries, patients recover fast from laparoscopic gallbladder surgeries.
• Patients are likely to be discharged on the very day of the surgery.
• Patients may return to daily exercise sooner.

How to Tell if You Should Undergo Laparoscopic Gallbladder Removal

Patients who have undergone abdominal surgery or those who have severe gallbladder complications may need open gallbladder surgery instead of laparoscopic gallbladder surgery. Your doctor will evaluate your condition thoroughly before giving you a recommendation.

Preparing for Gallbladder Removal

Your doctor will prepare you by giving you some instructions on what you should and should not do. If you are a smoker, you will have to quit smoking at least two weeks prior to the surgery. Also, you may not resume smoking until at least a year after since it interferes with your recovery.

You should not take anything at least eight hours before the surgery. This is because you may develop complications associated with the general anesthesia to be used.

Your doctor will make you aware of what is expected of you immediately before surgery. They will also prepare you psychologically by telling you of any possible pain you might go through. If you have any questions, you should discuss them with your doctor before the surgery.

You may be given an injection to help your blood from clotting. You may also be given compression gear to prevent blood clots in your legs.

Alternatives to Gallbladder Removal

There are a number of alternative treatments for gallstones.

• If you do not have any symptoms, you require no treatment. If your doctor monitors your symptoms and recommends treatment instead of surgery, you may not need your gallbladder removed.
• Your doctor may remove gallstones in your bile duct during ERCP, a procedure that allows your doctor to examine the pancreatic and bile ducts as well as remove gallstones through your mouth. Whether the doctor does so entirely depends on the sizes and locations of the gallstones. If during ERCP gallstones are detected, your doctor will suggest more tests and x-rays to further examine the gallstones.

In case of cancer of the gallbladder, you will probably be made to undergo chemotherapy or radiotherapy. You and the doctor will discuss these alternatives in detail before treatment.

How Laparoscopic Gallbladder Removal is Done

• The patient is put under general anesthesia and will be asleep during the surgery.
• A surgical instrument is inserted into the belly through an incision near the belly button.
• The surgeon uses a laparoscope to get a clear view of the patient’s organs on a monitor.
• The surgeon will then insert a cannula into the patient's belly to help him or her detach the gallbladder carefully from the liver bed.
• An x-ray is conducted on the patient to help the surgeon see gallstones blocking the ducts and study the organ's anatomy.
• The gallstones are either removed or left for a later operation through the mouth. This technique is known as ERCP (endoscopic retrograde cholangiopancreatography). If needed, the surgeon may perform open surgery to remove the gallstones.
• After carefully detaching the gallbladder from the liver bed, the surgeon will seal the incisions using absorbable stitches or surgical glue.

What if Gallbladder Removal Cannot Be Done or Completed Through the Laparoscopic Method?

There are a number of patients who cannot undergo laparoscopic gallbladder surgery. There are several factors that may make the surgeon opt for open gallbladder surgery. These factors include:

• Obesity
• A previous abdominal surgery
• An extremely enlarged gallbladder
• A scarred gallbladder
• Bleeding complications
• Inability to see the inner organs

The surgeon may inform you of the decision to use open surgery. In some cases, he or she may switch to open surgery during the operation. This is always a good decision and not an unnecessary complication of the procedure. The surgeon will always consider the patient’s condition and put the patient’s safety first.

What to Expect Afterwards

After your surgery is done, you will be required to get some rest until the effects of the anesthetics are gone. The nurse or doctor involved may give you pain relievers.

During the operation, the surgeon puts some carbon dioxide in your abdomen to help him get a clear view of your organs, and you may still have gas in your stomach after the surgery. This may cause discomfort and shoulder pain. The gas should go away within two days after the surgery.

In case you are an outpatient, you will be released a few hours after the surgery. You will not be allowed to drive yourself home and you should therefore arrange for a driver. You will also need someone to help you out at home for the first two days.

A prescription of antibiotics and pain relievers will be given to you. Your nurse will give you instructions on how to look after your wound. You will also be given appointments for follow-up on your condition for around two weeks.

The general anesthesia may have some side effects on you. Your thinking or judgment may be impaired. This can last for a day. Therefore, do not sign documents, drink alcohol, smoke, or drive for up to 48 hours.

Your doctor will make you aware of your stitches. If the incisions are clipped, the clips are removed after seven days. In most cases of this surgery, the surgeon will use dissolvable stitches. The time they take to dissolve depends on the type of surgery and conditions of a patient.

Recovering from Gallbladder Removal

Recovery varies from one patient to another, but normally takes two to three weeks. Your doctor will advise you on when you can resume your daily routine. For open gallbladder surgery patients, recovery time may last for around six weeks.

You can buy over-the-counter pain relievers if needed. Always try to follow the prescription your doctor provided before you left the hospital.

Avoid driving while you still feel sore or weak. The soreness should go away after seven days.