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    • Jason Cohen, MD, FACS
    • Yosef Nasseri MD, FACS, FASCRS
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Gallbladder Removal Surgery

Gallbladder removal surgery, also known as a cholecystectomy, is a common procedure that involves the removal of the gallbladder, the pear-shaped organ that sits below the liver and aids in digestion. Most people undergo the procedure after developing gallstones—small and hard formations that can cause pain or infection. The surgery is relatively safe. These days, surgeons perform the operation using minimally invasive techniques whenever possible. That allows most patients to return home the same day.
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What Causes Gallbladder Problems?

The gallbladder plays a role in digestion. It stores bile, which is created in the liver, and then releases it into the small intestine, where it helps the body break down food. Sometimes, hard formations called gallstones develop inside the gallbladder. Made of either cholesterol or bile, these small pieces can sometimes cause pain or infection. There are other forms of gallbladder disease, such as polyps or cancerous growths, but most gallbladder problems are caused by gallstones.

Why Would Doctors Recommend Gallbladder Removal Surgery?
A cholecystectomy is a common gallstone treatment method. A physician may recommend gallbladder removal if:
  • A patient experiences gallbladder pain due to gallstones
  • The gallbladder stones block the bile duct (a condition known as choledocholithiasis)
  • The gallbladder becomes inflamed or infected (a condition known as cholecystitis)
  • Gallstones cause the pancreas to become inflamed
Are There Any Risks?
Laparoscopic gallbladder surgery is a minimally invasive technique for removing the gallbladder. As such, it is a relatively low-risk procedure. Possible complications include:
  • General anesthesia risk
  • Infection to the incision area
  • Internal bleeding
  • Injury to the bile duct, small intestine, or liver
  • Blood clots
In general, the risk of complications correlates with overall health. The healthier you are, the fewer risks you face. There is also a very small chance that the surgeon will have to transition from a laparoscopic, or minimally invasive surgery, to open surgery. If the surgeon notices unexpected inflammation, for example, he or she may need to make a larger incision. That being said, some complications can be dangerous. When the intestines get trapped inside a hernia, it’s called strangulation, and it could lead to loss of blood supply to the area. To prevent the possibility of strangulation, doctors recommend hernia surgery for most patients. The question usually isn’t if a patient needs surgery, but when. Some can wait. Others can’t.
How Should I Prepare for the Procedure?
If you’re scheduled for surgery, you should take a few steps to prepare.
  • Fast for at least eight hours. You should avoid all food and drink in the hours leading up to the surgery, starting the night before.
  • Ask your doctor about any medications. You may need to stop taking certain medications and continue taking others.
  • Arrange transportation. Make sure you have a reliable way to get to and from the surgery. Be prepared in case a laparoscopic surgery turns into an open surgery and you have to stay an extra day in the hospital.
What Should I Expect During and After the Operation?

Before the procedure, you will be given general anesthesia. As soon as you’re unconscious and prepped for surgery, the surgeon will make a few small incisions in your abdomen. The surgeon will then insert a small tube fitted with a lighted camera. The camera will send real-time images to a monitor. The surgeon will use the screen as a guide while removing the gallbladder with surgical instruments. After removal, the surgical team may take special x-ray or ultrasound images in order to ensure that there are no problems with the bile duct or with loose gallstones. If at any time, the surgeon happens to notice scar tissue, or if bleeding occurs, then a larger incision (approximately six inches) may be required.

People may experience pain or discomfort in the affected area, particularly when lifting, bending, or coughing. Hernia pain is somewhat common but not universal; often a bulge appears without any unwanted sensations. Signs of strangulation include nausea, vomiting, and the sudden onset of pain. Anyone who feels these symptoms should call a doctor and discuss their options.

What Next?

After the procedure, you should feel relief from pain. Most likely, you’ll have no trouble digesting food. Since the gallbladder isn’t required for healthy digestion, most patients experience no ill effects.

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