What is Open Cholecystectomy

Open cholecystectomy is surgery to remove the gallbladder. The gallbladder is a pear-shaped organ that lies beneath the liver on the right side of the body. The gallbladder stores bile, which is a fluid that helps the body to digest fats.

Cholecystectomy is often done for inflammation of the gallbladder (cholecystitis). This condition is usually caused by a buildup of gallstones (cholelithiasis) in the gallbladder. Gallstones can block the flow of bile, which can result in inflammation and pain. In severe cases, emergency surgery may be required.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• A stone remaining in the common bile duct. The common bile duct carries bile from the gallbladder into the small intestine.
• A bile leak from the cyst duct that is clipped when your gallbladder is removed.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• Let your health care provider know if you develop a cold or an infection before surgery.
• Plan to have someone take you home from the hospital or clinic.
• Ask your health care provider how your surgical site will be marked or identified.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed from the surgical area.
• An IV tube may be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
• A breathing tube will be placed in your mouth.
• Your surgeon will make a cut (incision) in the upper abdomen to access your gallbladder.
• Your gallbladder will be removed.
• Your common bile duct may be examined. If stones are found in the common bile duct, they may be removed.
• After your gallbladder has been removed, the incisions will be closed with stitches (sutures), skin glue, or staples.
• Your incision will be covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given medicines as needed to control your pain.
• Do not drive for 24 hours if you were given a sedative.

Open Cholecystectomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain at your incision site. You will be given medicines to control this pain.
• Mild nausea or vomiting.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Activity

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider approves.
• Do not play contact sports until your health care provider approves.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative).
• Rest as needed. Do not return to work or school until your health care provider approves.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.

Contact a health care provider if:

• You develop a rash.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever.
• Your incision breaks open.

Get help right away if:

• You have trouble breathing.
• You have chest pain.
• You have increasing pain in your shoulders.
• You faint or feel dizzy when you stand.
• You have severe pain in your abdomen.
• You have nausea or vomiting that lasts for more than one day.
• You have leg pain.