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Gallbladder removed

This factsheet is for people who are planning to have gallbladder surgery (cholecystectomy), or who would like information about it. 

The gallbladder may need to be removed if it becomes diseased or damaged. Your care will be adapted to meet your individual needs and may differ from what is described here. So its important that you follow your surgeons advice.

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.  

Your gallbladder is a small, pear-shaped pouch in the upper right part of your abdomen (tummy). It stores bile, which is a fluid made by your liver, and used to help digest the fats that you eat. Bile is made of cholesterol, bile salts and waste products, and gallstones can form when these substances are out of balance. Gallstones can give you abdominal pain (particularly after a fatty meal), make you feel sick and give you a fever (a temperature higher than 37.5C). Your gallbladder may need to be removed if it becomes damaged by gallstones. If you have your gallbladder removed, bile dribbles continuously into your gut rather than only being released after meals.

Your GP may press gently with his or her fingers just below the ribs on the right side of your chest. This area may feel tender if you have an inflamed gallbladder. A blood sample may be taken from you for testing.

Your GP may send you for further tests including:

  • ultrasound scan - this uses sound waves to produce an image of the inside of your body
  • HIDA (hepatobiliary iminodiacetic acid) scan - X-ray images of the gallbladder are taken following injection of iodine dye

What are the alternatives?

If your symptoms are mild, or if surgery isn´t possible for medical reasons, there may be alternatives to having surgery to remove gallstones. Your surgeon will discuss any possible alternative treatments with you.

A gallbladder operation is usually done using keyhole surgery (laparoscopic cholecystectomy), which means your surgeon wont have to make a large cut in your abdomen.

Keyhole surgery is usually carried out as a day case, but you may need to stay overnight in hospital. The operation is done under general anaesthesia which means that you will be asleep during the procedure.

Your surgeon will explain how to prepare for your gallbladder surgery. For example, if you smoke you will be asked to try to stop as smoking increases your risk of getting a wound or chest infection and slows your recovery.

You will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.

At the hospital your nurse will explain how you will be cared for during your stay. Your nurse may check your heart rate and blood pressure, and test your urine.

You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.

Your surgeon and anaesthetist will visit you before your operation. This is a good time to ask any unanswered questions. Your surgeon will ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

During the laparoscopic operation, your surgeon will make two or three small cuts (about 5 to 10mm long) through the skin of your abdomen. One cut will be above, or just below, your navel (tummy button), and the others on the right side of your abdomen.

Your surgeon will then inflate your abdomen using carbon dioxide gas to make it easier to see your internal organs. He or she will then pass a laparoscope (a long, thin telescope with a light and camera lens at the tip) through one of the cuts. This allows your surgeon to view your internal organs on a monitor.

Specially adapted surgical instruments help move the internal organs and allow your surgeon to cut and remove the gallbladder. X-ray images may be taken during the operation, so that your surgeon can see if any gallstones are blocking your bile duct.

Afterwards, the instruments are removed and the gas is allowed to escape through the laparoscope. The skin cuts are closed with dissolvable stitches and covered with a dressing.

The operation takes 60 to 90 minutes.

You will be taken from the operating theatre to a recovery room, where you will come round from anaesthesia under close supervision. You will then be taken back to your room, where your nurse will check the wounds and record your heart rate and blood pressure at regular intervals.

You will need to rest until the effects of the general anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. If you do have any discomfort, discuss it with your nurse.

Dissolvable stitches will usually disappear in around one to three weeks, but this can take up to six weeks, depending on the type of stitches you have. Your nurse will give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment. You may also be given special compression stockings to wear after surgery to decrease the possibility of blood clots forming in your legs.

General anaesthesia temporarily affects your coordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If youre in any doubt about driving, please contact your motor insurer so that youre aware of their recommendations, and always follow your doctor/surgeons advice.

If you need pain relief, your doctor may prescribe you painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice. Your surgeon may give you painkillers when youre discharged from hospital.

You can return to your usual activities, including going back to work, after about a week. However, some people may need to rest for longer while others can return to work after a few days. Follow your surgeons advice about driving. You shouldn´t drive until you´re confident that you could perform an emergency stop without discomfort.

Gallbladder removal is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted but mostly mild and temporary effects of a successful treatment. An example of a side-effect is feeling sick as a result of the anaesthetic or painkillers.

You may feel some pain in your abdomen and shoulders. This is caused by the gas used to inflate the abdomen and usually disappears within 48 hours.

Many people have diarrhoea after having their gallbladder removed, because the bile salts irritate your digestive system. Eating plenty of high-fibre foods such as brown rice, wholemeal bread and pasta can help you absorb excess water and make your bowel movements firmer. Your GP may suggest the use of bulking agents such as methyl cellulose (Celevac) or Fybogel or may prescribe a medicine called colestyramine (Questran).

Complications

This is when problems occur during or after the operation. Most people aren´t affected but the main possible complications of any surgery are an unexpected reaction to the anaesthetic, excessive bleeding, infection or developing a blood clot in a vein in the leg (deep vein thrombosis, DVT). Most people are given compression stockings to wear during the operation to help prevent this.

There is a chance your surgeon may need to convert your keyhole procedure to open surgery. This means making a bigger cut on your abdomen. This will only be done if it is impossible to complete the operation safely using the keyhole technique.

Possible complications include the following.

  • You may have pain in your abdomen, bloating, wind and diarrhoea, which may need further investigation and treatment.
  • Rarely, your bile duct or other organs may become damaged during surgery. If this happens you may need further surgery.
  • Blockage of a blood vessel with a bubble of carbon dioxide gas may occur.

The exact risks are specific to you and differ for every person, so we havent included statistics here. Ask your surgeon to explain how these risks apply to you.

1. I have recently had my gallbladder removed and have had diarrhoea ever since - is this due to my operation?

You may have diarrhoea after having your gallbladder removed. This is usually caused by bile flowing directly from your liver into your small bowel as it can't be stored in your gallbladder. You may also find that you need the toilet more frequently. Diarrhoea usually improves within two weeks of having your gallbladder removed, but it can last for over a year. Your GP can offer you advice on the best ways to manage your diarrhoea.

Diarrhoea following gallbladder removal is common and can make everyday life more difficult. If you have diarrhoea for long periods of time, it can be very distressing. However, there are some things that you can do to help yourself.

  • Eat a high-fibre diet containing foods such as cereals, fruits and vegetables, and nuts. This will help to absorb excess water and bulk up your faeces, making them less soft.
  • Try not to eat foods that can make diarrhoea worse. These include spicy and fatty foods and dairy products.
  • Reduce the amount of caffeine you drink by having decaffeinated tea or coffee or naturally caffeine-free drinks such as water.
  • Ask your GP to recommend antidiarrhoea medicines to reduce the number of times you have to visit the toilet.
  • Wear a small pad in your underwear - this might help you to feel more confident.

If you have diarrhoea for long periods of time, it can make you feel very weak and tired. You can become dehydrated because food is passing quickly through your bowel before your body has time to absorb the benefits of the vitamins, minerals and water. It's very important that you drink as much water as you can. It's also important to drink plenty of fluid if you're increasing the amount of fibre you eat. Speak to your GP for advice on how to reduce your risk of becoming dehydrated.

Before you try any over-the-counter (OTC) medicines to help with your diarrhoea, it's very important that you talk to your GP. He or she will need to find out what is causing your diarrhoea in order to decide on the best medicine to give you. Some medicines will need to be prescribed by your GP.

Common medicines used to help with diarrhoea are:

  • loperamide hydrochloride (Imodium)
  • co-phenotrope (Lomotil)
  • codeine phosphate

These medicines work by slowing down the time it takes for food to pass through your digestive system. Using them may not get rid of your diarrhoea completely but may help to make it less severe.

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

You can manage very well without a gallbladder. After you have had your gallbladder removed, bile dribbles continuously into your intestine rather than only being released after meals. You shouldn't have any problems digesting food after having your gallbladder removed.

If you have had surgery to your abdomen, it can be a shock to your system. Usually, you don't have to stop eating particular foods after gallbladder surgery, but some people can get increased wind (gas), bloating or diarrhoea after meals for two to three weeks following gallbladder surgery.

Your doctor may advise you to eat a low-fat, high-fibre diet. Fats in your diet can make you produce more bile and you will produce less if you eat a low-fat diet. Dietary fibre can give you protection from the constant dribble of bile into your intestine that follows gallbladder removal. Dietary fibre may also reduce symptoms of diarrhoea as it bulks up your faeces and makes them firmer. Sources of dietary fibre include brown rice, wholemeal bread and pasta. It's important to drink plenty of fluid if you're increasing the amount of fibre you eat.

Contact your GP if you have any concerns regarding your diet after having your gallbladder removed.

3. How much time will I have to spend off work after having my gallbladder removed?

If you have had a laparoscopic cholecystectomy (removal of the gallbladder using keyhole surgery), you may be allowed to return home on the same day but usually it will be the day after your operation. You will probably be fit enough to return to work about one week after your operation, depending on the nature of your job. If you had open surgery, your recovery time will be longer than with laparoscopic cholecystectomy and you will usually resume daily activities and return to work in three to five weeks.

Gallbladder removal is a major abdominal operation and you will feel a certain amount of pain after surgery. You should start feeling better once you reach home, so contact your GP if the pain doesn't gradually start to go away during the week following your operation. Your surgeon or nurse will advise you as to when you can remove your dressings and wash or shower.

Your level of activity will depend on how you feel. Gradually increase your level of activity during the week after your operation depending on how you feel. If you're taking medicines for any pain, you may not be able to drive. Ask your GP or pharmacist if you're unsure whether you can drive or not.

If you have had a laparoscopic cholecystectomy, you will usually be able to return to daily activities and work within about a week of your operation. If your job involves manual labour or heavy lifting, you may need a bit more time away from work. Contact your GP if you're unsure what amount of activity you should be doing.

If you have had open surgery, your recovery time will be longer than with laparoscopic cholecystectomy. Open surgery is a major operation which requires a longer stay in hospital followed by several more weeks at home to recover.

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