Gallbladder Surgery - Laparoscopic Cholecystectomy

This is the surgical removal of the gallbladder using keyhole surgery. The gallbladder is a small sac attached to the liver that stores bile. The reason for removing the gallbladder is the presence of gallstones causing attacks of pain, jaundice and inflammation of the gallbladder or pancreas.

In the past, most gallbladders were removed through a long incision below the right ribs. These days however, most gallbladders are removed laparoscopically (keyhole surgery through small incisions). This is still a major operation but recovery time is much faster.

 

Before Your Operation

• Do not eat or drink anything for 6 hours before your operation.
• If you are diabetic, do not take your insulin or diabetes tablets the morning of operation.
• Take your other tablets with a sip of water.
• If you are taking drugs that thin the blood let your surgeon and anaesthetist know a week before the surgery as some may need to be stopped.
  
  

Anaesthesia

The surgery is performed under general anaesthetic. Local anaesthetic and pain relief are administered at the end of the operation.

 

 

 

The Operation

Laparoscopic gallbladder surgery is performed with four small cuts; one near the belly button and three in the upper abdomen. The tummy is filled with gas to create a working space. The gallbladder is dissected then an x-ray test (called a cholangiogram) is performed to check if any stones have slipped beyond the gallbladder into the bile duct. If so then is it often possible to remove them during surgery otherwise they can be removed endoscopically a few days after surgery. After the x-ray test, the duct to the gallbladder is clipped with titanium clips and the gallbladder is removed and the incisions are closed. Sometimes a drain that goes to the outside is placed and kept for a day or two if the gallbladder was very inflamed or there were stones in the duct. This is often removed before you go home or shortly after.

 

After the Operation

After your operation you may feel pain in your shoulders. This is fairly common and tends to settle within 24 hours. Any pain, discomfort or nausea will be controlled by medications and most patients are able to go home the day after surgery.

Possible Risks of Gallbladder Surgery (Cholecystectomy)

Please note: Serious complications are uncommon. Dr Zarrouk and Dr Kirby take many steps to prevent problems. Your personal risk depends on your overall health.

General Risks (Can occur with any surgery)

• Infection: An infection can happen at the incision sites or inside the abdomen. This is treated with antibiotics. Occasionally, the infection may need to be drained with a needle or further surgery.
• Bleeding: There is a small risk of bleeding during or after surgery. This is usually managed during the operation. Blood transfusions are rarely needed. If the bleeding occurs soon after surgery then reoperation may be needed to control the bleeding.
• Blood Clots: Surgery can increase the chance of blood clots in the legs or lungs. You will be encouraged to walk early, and may be given special stockings or medication to help prevent this.
• Heart or Kidney Issues: The stress of surgery and anaesthesia can rarely affect the heart, or temporarily impact kidney function.
• Chest infection or pneumonia (~2-5 per 1,000): Anaesthesia and pain cause shallow breathing and may lead to chest infection. Deep breathing exercises, antibiotics, and physiotherapy prevent or treat it; severe cases may need ICU.
• Reactions to Anaesthesia: Serious allergic or bad reactions to anaesthesia medicines are very rare.
• Death: The risk of death from this surgery is extremely low (1 in 1000) for most patients, but it is a risk with any major operation.

Specific Risks of Gallbladder Surgery

• Injury to the Bile Duct: The main bile tube that carries bile from the liver to the intestine can be accidentally injured. This occurs in 1-5 per 1000. This risk is higher in patients with recurrent infections. This is a serious complication and would often require endoscopic treatment for minor cases or complex surgery for major ones. .
• Bile Leak:(very rare, 0.5%) Bile can sometimes leak from the liver or the bile duct after surgery. This often requires reoperation for washout and possible endoscopic treatment.
• Retained Stone: Some patients may have a stone that has slipped into the bile duct. This can cause pain or jaundice and may require an endoscopic procedure (ERCP) to remove it.
• Spilled Gallstones: Gallstones can occasionally spill into the abdominal cavity during surgery. This may lead to infection or abscesses, which might need drainage or further surgery to remove it.
• Injury to Nearby Organs: Rarely, instruments can accidentally injure nearby structures like the intestines, liver, or blood vessels. This often requires surgical repair.
• Need to Switch to Open Surgery: Sometimes, keyhole (laparoscopic) surgery cannot be completed safely. The surgeon may need to switch to a traditional open surgery with a larger incision. This is not a complication, but a safety decision. It means more pain and a bigger scar and a longer hospital stay (usually 7 days).
• Partial or Incomplete Removal: In rare, difficult cases, it may be unsafe to remove the entire gallbladder due to severe scarring or inflammation. The surgeon may need to remove only part of it or place a temporary drain. Some patients may require further surgery.
• Port-site Hernia: A weakness can develop at an incision site, allowing tissue to bulge through. This may require surgical repair if it becomes a problem.
• Diarrhoea: Without a gallbladder, bile flows directly into your intestine. This can cause loose stools or diarrhoea for some people. This is seen in about 20% of patients but tends to improve with time. Rarely, patients develop long term diarrhoea that requires medications to bind the bile salts.
• Post-cholecystectomy syndrome (persistent pain/diarrhoea; 4-10%): Gallbladder type pain may continue in some patients due to leftover stones, bile flow issues, or sphincter problems. Antispasmodic drugs, ERCP, or rare re-operation help.
• Pancreatitis: Rarely, irritation from a stone or the procedure can cause inflammation of the pancreas.

Special Considerations

• For Pregnant Patients: Surgery carries an increased risk of premature labour or pregnancy loss. Your surgeon will time the surgery carefully and monitor the foetus closely.

Wound Care

Your incisions will have buried (dissolvable) sutures under the skin, covered by paper tapes (Steri-Strips) and waterproof dressings.

• Leave dressings on for 2 days, then gently remove them. The Steri-Strips will peel off naturally in the shower over 7-10 days.
• You can shower from day 1—just pat wounds dry gently (no rubbing). Avoid baths or swimming until Steri-Strips are gone.
• A small amount of clear or slightly pink drainage is normal for the first few days.
• Contact us or see your GP if you notice:
  • Thick yellow/green drainage, pus, or foul odour
  • Redness, swelling, warmth, or increasing pain around incisions
  • Fever over 38°C

Diet After Gallbladder Surgery

There is no special long-term "gallbladder diet." Your body will adapt to digesting food without its storage pouch.

Initially after surgery, start with a light, bland diet (such as toast, crackers, rice, steamed chicken, bananas, or soup) until any nausea passes and your appetite returns.

As you recover, you can return to your normal, healthy diet. However, pay attention to how your body reacts. Some people find that full-cream dairy (like milk, cream, or ice cream) and fatty or greasy foods can trigger diarrhoea with a sudden urgency to get to the toilet. This often happens after a meal like breakfast.

If you notice this happening, simply try avoiding those specific foods for a while. You can reintroduce them later in smaller amounts to see if your tolerance has improved.

Listen to your body and adjust your diet based on what feels comfortable for you.

Activity

Walking after surgery is encouraged to reduce the risks of blood clots and respiratory complications. After going home start with short walks two to three times a day and increase the distance. Heavy lifting should be avoided to reduce the risks of hernia at the operation site.

Returning to Work

Returning to work depends on the kind of operation and the type of work you do. The majority of people need two to four weeks off work to recover. It is normal to feel tired and you may need more sleep than usual.

Driving

The time it takes to get back behind the wheel varies from person to person. Most patients can resume driving 7 days after the surgery. Before you drive you must be off all pain killers with no pain and your movement and strength must be able to cope with an emergency stop.

Follow-up

Please make a follow up appointment 4 to 6 weeks after your surgery to see Dr Zarrouk to monitor your progress and check the tissue results. 

Alternatives to Gallbladder Surgery

Surgery (cholecystectomy) remains the most effective long-term solution for symptomatic gallstones, but non-surgical options suit select cases. These rarely provide permanent cures and often manage symptoms temporarily.

• Watchful waiting: Ideal for asymptomatic stones (no pain history); 70-80% never cause problems. Regular ultrasounds monitor.
• Diet and lifestyle changes: Low-fat diet, gradual weight loss, and exercise may reduce attack frequency but won't dissolve stones.
• Medications (ursodeoxycholic acid): Slowly dissolves small cholesterol stones over 6-24 months, but recurrence is high (50% within 5 years) with side effects like itching, nausea, and diarrhoea.
• Shock wave lithotripsy: Sound waves break stones; extremely rarely used today due to high failure rates.
• ERCP stone removal: Endoscopic extraction for bile duct stones only (not gallbladder stones).
• Endoscopic/percutaneous gallbladder drainage: For high-risk patients unfit for surgery; temporarily drains infection (cholecystostomy) without removal.

Discuss which fits your situation with Dr. Zarrouk and Dr Kirby.