Surgery Overview
In
open gallbladder surgery (cholecystectomy), the surgeon removes the
gallbladder through a single, large cut (incision) in the
abdomen. You will need general anesthesia, and the surgery lasts 1 to 2 hours.
The surgeon will make the incision either under the border of the right rib
cage or in the middle of the upper part of the abdomen (between the belly
button and the end of the breastbone).
Doctors do most open
gallbladder surgeries after trying first to remove the gallbladder with
laparoscopic surgery. A few people have conditions that require open
gallbladder surgery. For more information, see the Why It Is Done section
below.
After surgery to remove the gallbladder, bile flows from
the liver (where it is produced) through the
common bile duct and into the small intestine. Because
the gallbladder is gone, bile no longer is stored between meals. In most
people, this has little or no effect on digestion.
What To Expect After Surgery
Surgery usually involves a hospital
stay of 2 to 4 days or longer. Most people can return to their normal
activities in 4 to 6 weeks. Open surgery involves more pain afterward and a
longer recovery period than laparoscopic surgery.
This
surgery leaves a moderately large scar [4 in. (10.2 cm) to
8 in. (20.3 cm) long].
No special diets or other precautions are needed after surgery.
Why It Is Done
Several
conditions may lead to surgery to remove the
gallbladder. Conditions that may require open rather than laparoscopic surgery
include:
- Severe inflammation of the bile duct or
gallbladder.
- Inflammation of the abdominal lining (peritonitis).
- High pressure in blood
vessels in the liver (portal hypertension). This is caused by
cirrhosis of the liver.
- Being in the third
trimester of pregnancy.
- A major bleeding disorder or use of
medicines to prevent blood clotting (blood thinners or
anticoagulants).
- Scar tissue from many previous abdominal
surgeries.
- Abnormal anatomy in the abdomen.
In 5 to 10 out of 100 laparoscopic gallbladder surgeries in
the United States, the surgeon needs to switch to an open surgical method that
requires a larger incision.1 Examples of problems that
can require open rather than laparoscopic surgery include unexpected
inflammation, scar tissue, injury, or bleeding.
How Well It Works
Surgery reduces the risk that
gallstones will come back. But gallstones sometimes
form in the bile ducts years after cholecystectomy, although this is not
common.
Risks
The possible complications of open gallbladder
surgery include:
- Injury to the common bile
duct.
- Excessive bleeding.
- Infection of the surgical
wound.
- Injuries to the liver, intestines, or major abdominal blood
vessels.
- Blood clots or
pneumonia related to the longer recovery period after
open surgery.
- Risks of general anesthesia.
After gallbladder surgery, some people have ongoing
abdominal symptoms, such as pain, bloating, gas, or diarrhea (postcholecystectomy syndrome).
What To Think About
Open gallbladder surgery has been
done safely for many years.
In most cases, laparoscopic surgery
has replaced open surgery to remove the gallbladder. Recovery is much
faster and less painful than after open surgery.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Glasgow RE, Mulvihill SJ (2010). Treatment of gallstone disease. In M Feldman et al., eds., Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed., vol. 1, pp. 1121–1138. Philadelphia: Saunders.
Credits
| By | Healthwise Staff |
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| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
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| Specialist Medical Reviewer | Arvydas D. Vanagunas, MD - Gastroenterology |
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| Last Revised | July 15, 2011 |
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Glasgow RE, Mulvihill SJ (2010). Treatment of gallstone disease. In M Feldman et al., eds., Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed., vol. 1, pp. 1121–1138. Philadelphia: Saunders.
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