How Does Your Gallbladder Function?

The gallbladder is located under the liver in the upper right portion of your abdomen. Bile secreted by the liver is stored in the gallbladder. When you eat fatty foods, the bile is released from the gallbladder to the intestine to aid in digestion. Sometimes stones develop in the gallbladder, interfering with proper function. The majority of gallstones are caused by too much cholesterol in the bile.

For more information or to schedule an appointment with our general, thoracic, vascular or bariatric surgeons, call (206) 341-0060.

A Guide to Gallbladder Removal

A cholecystectomy (removal of the gallbladder) is done when the gallbladder becomes infected or when gallstones are present, causing symptoms. More than 500,000 Americans undergo gallbladder surgery each year. Once the organ is removed, the main bile duct takes over the function of the gallbladder by carrying more bile from the liver during digestion.

Surgery Overview

Removal of the gallbladder is a safe and effective procedure to eliminate gallstones. The procedure is performed under general anesthesia, sometimes requiring a hospital stay of one or more nights. In most cases patients go home the same day. You will meet with your anesthesiologist prior to surgery and on the day of the procedure to address any questions or concerns. The surgery generally takes one to two hours to complete.

Gallbladder removal series

The most common way to remove the gallbladder is called laparoscopic cholecystectomy; an operation on the abdomen using small incisions.

The benefits of a laparoscopic cholecystectomy are similar to other minimally invasive surgeries:

  • Smaller incisions mean less postoperative discomfort
  • Quicker recovery
  • A return to work and other regular activities sooner
  • Scarring is minimized

Read this guide to learn more about laparoscopic gallbladder removal.

When laparoscopic cholecystectomy is not feasible due to a patient's anatomy, inflammation of the gallbladder or other reasons, an open cholecystectomy will be performed. In this procedure, the gallbladder is removed through a surgical incision high in the right abdomen, just beneath the ribs. Patients will usually be in the hospital two to three days, with a return to regular activities in two to three weeks.

Occasionally, the need to perform open cholecystectomy will become apparent after starting with the laparoscopic approach. At this point the procedure can be converted to the open procedure. In rare situations, the gallbladder cannot be removed safely and may require another operation on another day: this occurs in less than one in 100 patients.

Gallbladder Surgery Removal Timeline

Two Weeks Before Surgery

  • Smokers should stop smoking to help prevent pneumonia and infection after surgery.

One Week Before Surgery

  • Unless your surgeon advises otherwise, do not take aspirin or aspirin-containing compounds, including: Excedrin, Alka-Seltzer, Aleve (naproxen), fenoprofen, ketoprofen, Relafen, piroxicam, sulindac and Tomatine.
     
  • Visit the lab for preoperative tests and the Preanesthesia Assessment Clinic as scheduled by your surgeon.
     
  • If you have not done so, check if your medical insurance plan requires pre-authorization or a second surgical opinion prior to your procedure.

One Day Before Surgery

  • Call your surgeon's office between 1 and 5 p.m. to find out your check-in time for the following morning.
     
  • Shower with an antibacterial soap, such as Dial or Lever 2000, the night before and the morning of your surgery.
     
  • Do not eat solid foods after midnight the night before your surgery. After midnight, consume no more than 16 ounces (two cups) of clear liquid, up to two hours before check-in. Clear liquids include water, apple juice, black coffee, tea, carbonated beverages and plain Jell-O. No milk products, alcohol, fruit juices with pulp, chewing gum or tobacco are permitted.
     
  • Some medical conditions may require patients to stop all food and drink, even clear liquids, after midnight. Such conditions include, but are not limited to: pregnancy, slow stomach emptying, diabetes, extreme obesity and severe heartburn. Ask your anesthesiologist or surgeon if you suspect one of these conditions applies to you.

The Day of Surgery

  • Report to the Admitting Department
  • Follow your surgeon's instructions for taking your regular medications.
  • You will be fitted with compression stockings the day of your surgery. The stockings help prevent blood clots from forming in your legs during and after surgery. They will be removed before your discharge home.

After Surgery

  • Pain medication — You will receive instructions for taking Tylenol and ibuprofen every six hours for several days, as well as receive a prescription for pain medication should you need it to keep you comfortable.
     
  • Resuming activity — Continue walking as you recover. You may resume normal activity when your discomfort has subsided. Save strenuous activity and heavy lifting until pain at the incision site(s) has resolved. You may return to work when comfortable, usually five to seven days after surgery.
     
  • Driving — You may drive when you no longer require pain medication, usually three to seven days after surgery. Do not drive while taking pain medication.
     
  • Diet — There are no restrictions other than diets previously recommended for certain medical conditions, such as high blood pressure. However, you should avoid fatty and deep fried foods for a few days. Emphasize fresh fruits, vegetables, bran and liquids to help prevent any constipation that can result from taking pain medication.
     
  • Wound healing — Your incisions will be closed with sterile tape strips (Steri-Strips) that act like stitches, and sometimes surgical glue. You may shower or bathe with the tape strips in place. Remove the strips when they start to curl and come off, usually 10 to 14 days after surgery. Surgical glue will also peel off after about 10 days. Any minor pain at the incision sites should decrease over time. View the postoperative care instructions.
     
  • Follow-up visit — In many cases, it is not necessary to follow up with your surgeon. A follow-up visit will be provided if your surgeon thinks it is warranted. A phone number to the clinic will be provided should you have any questions at any time.  

Risks of Gallbladder Removal Surgery

Complications during or following cholecystectomy are rare. Possible risks associated with the surgery include:
 

  • Signs of bleeding in the recovery room.
  • Remaining stones in the bile duct not detected on X-ray that may require another procedure to be removed; this occurs in about two in 100 patients.
  • Injuries to the bile duct or intestine. This occurs in less than three in 1,000 patients.
  • Infection in one or more of the incision sites.
  • Blood clots in the veins of the legs.

When to Call the Doctor

If you have questions or problems, do not hesitate to contact your surgeon's office. The following symptoms are reasons to contact our office immediately:

  • A fever higher than 101º F (38.3º C).
  • Increased redness, swelling or drainage from your incisions.
  • You have questions about your care.