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If you have any problems after discharge you should
contact your own GP.
Stitches will be removed one week after your
operation by your GP.
Return to work is usual in approximately 14 days
depending on your occupation.
After open surgery:
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Pain relief consisting of injections may be needed
for the first 24 hours.
Fluids must be restricted to prevent the risk of
vomiting in the first few days, therefore you may
have a drip in your arm to give intravenous fluids
until normal eating and drinking can be resumed.
You may have a redivac/drain may be inserted into
the abdomen to prevent the accumulation of blood
or bile following surgery.
Early ambulation is encouraged, to reduce the risk
of thrombosis(clots) and the development of chest
infections.
Discharge from hospital usually occurs 3 to 7 days
after surgery.
The stitches will be removed before discharge or a
few days late.
Full recovery from the operation will take place over
the following month.
Most people need 2 to 4 weeks recovery before
returning to work.
People can live perfectly safely without their
gallbladder. However, in some people eating fatty or
fried food may produce a little discomfort in the
upper abdomen, because a ‘surge of bile’ contraction
of the gallbladder is no longer possible.
What would happen if the condition were not
treated?
Untreated gallstones may continue to cause bouts of
severe pain. Gallstones increase the likelihood of
inflammation of the gallbladder (cholecystitis). An
abscess can develop within the gallbladder, however, this
is rare. If the gallstones get stuck in the bile duct system
they may stop the flow of bile from the liver to produce
jaundice. Gallstones in the bile ducts may also prevent
the release of juices of the pancreas to produce
inflammation (pancreatitis).
‘This sheet acts as a guide for your surgical procedure.
It has been given to you because it relates to your
condition and may help you to understand it better. It
does not necessarily describe your problem exactly. If
you have any Questions, Please as your doctor.
Reference:
G “Patient Wise”, Medical
& Health Information for Patients
G www.prodogy.nhs.uk
Compiled at the Pre-operative Assessment Clinic, St. Luke’s
General Hospital, Kilkenny.
Our ref: NM/MN
In consultation with surgeons Mr. Wilson and Mr. Balfe, St.
Luke’s General Hospital.
Reviewed: 09/08/2009
Designed and Printed by Modern Printers: 056 7721739
Patient information for
Gallstone/Cholecystectomy.
What are gallstones?
Gallstones are stones that are formed when the components
of bile solidify and form crystals. These stones can range
from the size of a grain of sand to the size of a golf ball, the
gallbladder may contain anywhere from one stone to
hundreds.
The gallbladder itself is a pear shaped sac that lies on the
under surface of the liver. It connects to the biliary ductal
system through the cystic duct. The primary job of the
gallbladder is to collect and concentrate bile, which is
secreted continuously by the liver, until the bile is needed to
aid digestion. Gallstones may be present and cause no
symptoms. However, when fatty foods are eaten this causes
the gallbladder to contract and go into spasm and severe
pain can be experienced. Sometimes bloating wind and
indigestion may occur as a result of gallbladder disease.
If, when the gallbladder contracts, stones pass from the
gallbladder into the bile ducts, they may obstruct the flow of
bile. This may produce yellow jaundice (discolouration of
the skin). The jaundice occurs because the yellow pigment
in the bile cannot leave the liver and overflows into the
blood. This pigment is also responsible for the normal
brown colour of the bowel motions. When bile does not
reach the intestine because of stones, the bowel motions
become pale. The urine also becomes dark, as the bile
pigments produced by the liver overflow into the urine.
When jaundice has been present for a long period of time,
itching of the skin occurs due to the build-up of bile salts in
the skin.
Why do gallstones occur?
Gallstones may occur at any age. They are present in about
one in ten of the population over the average age of 40.
During and after pregnancy due to hormone changes the
likihood of having gallstones is increased. Infection is then
more likely. With certain diseases or operations of the small
bowel, cholesterol stones may form. In some blood
disorders where the red cells are destroyed, more bile
pigment is produced. This may also result in gallstones.
What does the treatment involve?
Cholecystectomy is an operation to remove the gallbladder. It
is performed using video-telescopic visualisation of the
gallbladder and surrounding vital structures. The patient is
given a general anaesthetic. This is the treatment of choice for
the majority of patients. The gallbladder can be removed by
‘keyhole surgery’ or normal open operation. Keyhole surgery
involves having the gallbladder removed via small puncture
holes, usually four small incisions, made in the abdominal
wall. The abdomen is inflated with carbon dioxide gas. This
distension allows for easier viewing and creates a workspace for
the surgery performed. (This gas is removed once surgery is
ended). The gallbladder is identified and the artery supplying
it and the duct tube leaving it are identified, clipped and
divided. The gallbladder is removed through one of the
puncture wounds. Small stitches are inserted in the skin. The
main advantage of this method of surgery is that the period of
recovery is far shorter than open operation. However, if you
have had repeated infection of the gallbladder or it is heavily
inflamed, it may be safer for the gallbladder to be removed by
open operation. If your surgeon anticipates difficulties he will
advise you to have an open operation. It may not be possible
to assess the gallbladder adequately except by use of a telescope
through a keyhole incision. It is important to understand that
following this examination or if any difficulties are
encountered during keyhole surgery, it is in your interest that
your surgeon is free to proceed with the open operation, for
maximum safety.
G Infection
G Haemorrhage or bleeding
G Deep venous thrombosis (in order to help prevent this,
patients are given injections of low molecular heparin
and are fitted with elastic stockings).
With Laparoscopic (key hole) surgery, certain complications
can occur although rare:
G There is often a little swelling around the wound sites
for a couple of weeks and sometimes some bruising.
G Sometimes on putting gas into the abdomen bleeding
can occur.
G Collection of serous fluid in the abdomen.
G Damage to the duct.
G Bile and stone spillage.
G Damage to the surrounding organs.
G Perforation.
G Infection.
What to expect after treatment?
Following Laparoscopic cholecystectomy:
You may experience some shoulder tip pain, this will wear
away gradually but you may need some pain control to
help you to deal with it. Pain relief may be required for 24
to 48 hours.
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Complications
A risk of serious complications after this kind of surgery is low.
However no operation can be carried out without risk. The
following risks are rare but can occur:
G Risk of General Anaesthetic (1/30,000 risk of serious
adverse event)
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A light diet may be started the evening of your
surgery as advised by your doctor.
Discharge from hospital is expected to take place the
same day of your surgery but may depend on the type
of surgery that you have had.
Sometimes a redivac drain is put in during your
surgery to assist in the drainage of bile and will be
removed the next day, this may result in you been
kept over night in hospital.
You may be able to shower 24 hours after surgery if
you feel able. Replace your wet dressings after you
shower with dry clean ones.
You will be given painkillers to take when you get
home, these may be required for 48 hours after your
surgery.
You will be advised to rest at home for the first 24 to
48 hours to recover from your anaesthetic and to
avoid alcohol or operating any type of machinery.