Cholecystectomy

What Is It?

Cholecystectomy is the surgical removal of the gallbladder, the small saclike organ located near the liver in the upper right-hand side of the abdomen. The gallbladder stores bile from the liver. Bile helps your body to break down and absorb fats. There are two ways to remove the gallbladder:

• Traditional surgery — The surgeon cuts open the abdomen and removes the gallbladder through an incision that is about 6 inches long.
• Laparoscopic surgery — The surgeon makes four small (less than an inch) incisions, and uses a laparoscope (a tubelike instrument with a camera for viewing inside the abdomen) to guide surgical instruments to the gallbladder, where the gallbladder is cut away from the liver and removed through one of the small incisions.

Currently, surgeons remove about 500,000 gallbladders in the United States each year. In about 90 percent of patients, laparoscopic surgery is used because it requires a shorter hospital stay, is less painful and has a shorter recovery period than traditional surgery. In the remaining 10 percent, traditional surgery may be necessary because the patient has significant abdominal scarring from prior surgery or has a higher risk for complications during surgery.

Most people have no side effects from living without a gallbladder. Bile can pass directly from the liver to the intestines, so the gallbladder usually is not missed.

What It's Used For

Surgeons remove gallbladders to prevent complications from gallstones, which are rocklike nuisances that can form inside the gallbladder. Gallstones can produce symptoms as simple as pain after eating, but also can lead to cholecystitis or pancreatitis. Cholecystitis is an inflammation or infection of the gallbladder that develops when a gallstone blocks a bile duct (or tube) that leads from the gallbladder to the intestine. Cholecystitis produces fever, nausea or vomiting, and pain in the upper right-hand side of the abdomen. Pancreatitis is an inflammation of the pancreas that can be caused by a gallstone blocking the duct coming from the pancreas. This leads to pancreatic enzymes irritating and inflaming the pancreas. Pancreatitis is dangerous and can be life threatening. Symptoms of pancreatitis include pain in the upper-middle part of the abdomen, nausea or vomiting.

Preparation

There are no specific preparations for gallbladder surgery. About one week before surgery, you will need to stop taking aspirin and other blood-thinning medications. Beginning at midnight on the night before your surgery, you must not eat or drink anything. This reduces the risk of vomiting during surgery.