What is laparoscopic gallbladder removal surgery?

Laparoscopic gallbladder surgery (cholecystectomy) removes the gallbladder through several small cuts (incisions) in the belly. The surgeon inflates your belly with air or carbon dioxide in order to see clearly.

The surgeon inserts a lighted scope attached to a video camera (laparoscope) into one incision near the belly button. The surgeon then uses a video monitor as a guide while inserting surgical tools into the other incisions to remove your gallbladder.

Before the surgeon removes the gallbladder, you may have a special X-ray procedure called intraoperative cholangiogram. It shows the anatomy of the bile ducts.

The surgery usually takes 2 hours or less. You will need general anesthesia.

After surgery, bile flows from the liver (where it is made) through the common bile duct. It then flows into the small intestine. Without a gallbladder, the body can no longer store bile between meals. In most people, this has little or no effect on digestion.

In 5 to 10 out of 100 laparoscopic gallbladder surgeries in the United States, the surgeon needs to switch to an open surgery that requires a larger incision. This can happen when there are problems such as unexpected inflammation, scar tissue, injury, and bleeding.

Activity

• Have your child rest when your child feels tired.
• Ask your doctor about what type of daily activity is safe for your child.
• Allow your child's body to heal. Don't let your child move quickly or lift anything heavy until after you see the doctor for your child's first follow-up appointment.
• Many children are able to return to normal activities 1 to 2 weeks after surgery. It may be longer for more active sports.

Diet

• Start to offer small amounts of food when your child feels like eating. Your child may need to avoid fatty foods like fried foods or cheese for a while. They can cause symptoms, such as diarrhea and bloating.
• Have your child drink plenty of fluids. If your child has to limit fluids because of a health problem, talk with your doctor before you increase how much your child drinks.
• If your child's bowel movements are not regular right after surgery, you can help your child to avoid constipation and straining. Have your child drink plenty of water. The doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.

Incision care

• If there are strips of tape on the cuts (incisions) the doctor made, leave the tape on for a week or until it falls off.
• Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
• You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing. Change the bandage every day.

Hygiene

• Your child may shower 24 to 48 hours after surgery, if your doctor okays it. Pat the incisions dry. Your child should not swim or take a bath for the first 2 weeks, or until your doctor tells you it is okay.

Laparoscopic gallbladder surgery is generally safe and effective. Surgery removes a diseased gallbladder and gets rid of gallstones. It does not remove stones in the common bile duct. Gallstones can form in the common bile duct years after the gallbladder is removed. But this is rare.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery and what will happen. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

• A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

The overall risk of laparoscopic gallbladder surgery is very low. The most serious possible complications include:

• Infection of an incision.
• Internal bleeding.
• Injury to the common bile duct.
• Injury to the small intestine by one of the tools used during surgery.
• Risks of general anesthesia.

Other uncommon complications may include:

• Gallstones that remain in the abdominal cavity.
• Bile that leaks into the abdominal cavity.
• Injury to blood vessels in the belly, such as the major blood vessel carrying blood from the heart to the liver (hepatic artery). This is rare.
• A gallstone being pushed into the common bile duct.
• The liver being cut.

More surgery may be needed to repair these complications.

After gallbladder surgery, some people keep having belly symptoms, such as pain, bloating, gas, and diarrhea (postcholecystectomy syndrome).

You may have gallbladder surgery as an outpatient, or you may stay 1 or 2 days in the hospital.

Most people can return to their normal activities in 7 to 10 days. People who have laparoscopic gallbladder surgery are sore for about a week. But in 2 to 3 weeks they have much less discomfort than people who have open surgery.

After surgery, your child will likely feel weak and tired for several days.

Your child's belly may be swollen. There might be pain in the belly or shoulders for about 24 hours. Your child may have gas or need to burp a lot at first.

A few children get diarrhea.

Laparoscopic gallbladder surgery is the most common method to remove a diseased gallbladder.

This surgery is used most often when no factors, such as scar tissue from previous belly surgeries, are present. If you have factors that may complicate laparoscopic surgery, your doctor may choose to do an open surgery.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, your child's surgery may be canceled. If your doctor told you to have your child take any medicines on the day of surgery, have your child take them with only a sip of water.
• Follow the doctor's instructions about when your child should bathe or shower before the procedure. Do not apply lotion or deodorant.
• Your child may brush their teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that's a reminder of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by the anesthesia provider. Your child will be asleep during the surgery.
• The surgery will take about 1 to 2 hours.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery staff will monitor your child's condition. The doctor will talk to you about the surgery.