What is a cholecystectomy?

A cholecystectomy is surgery to remove the gallbladder. It is usually done using keyhole surgery, when a tiny video camera and surgical equipment are inserted through 4 small cuts in the abdomen.

Why is a cholecystectomy procedure performed?

The gallbladder is a small organ that sits just below the liver on the right side of your abdomen. It collects and stores bile from your liver, which is used by the gut to help digest food.

Sometimes the gallbladder becomes blocked with gallstones that can cause pain, bloating, nausea and vomiting. Other complications can also occur, including inflammation of the gallbladder, inflammation of the pancreas, jaundice and infection.

In these cases, a cholecystectomy is performed under general anaesthetic to remove the gallbladder.

Sometimes, gallstones can move into your common bile duct. Bile ducts are 'pipes' that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. A cholecystectomy and exploration of the bile duct is a procedure to remove your gallbladder as well as any stones found in your common bile duct.

How do I prepare for the procedure?

If you need to have a cholecystectomy, you will be asked to eat nothing the night before the surgery. If you need to take medications, you may have a sip of water. You should have nothing at all 4 hours before the surgery.

Your surgeon will discuss with you whether to stop taking any medicines or supplements. Make sure you follow all the instructions from your doctor.

Many people go home the same day as the operation, but you may need to stay in hospital. Make sure you arrange for someone to be with you after the surgery because the anaesthetic will make you drowsy.

What happens during the procedure?

Most cholecystectomies are performed laparoscopically, which means they use keyhole surgery. The surgeon will make 4 small cuts (incisions) in your abdomen so they can introduce a piece of equipment known as a laparoscopic telescope through one of the incisions. This will allow them to see inside your abdomen.

They will then pass metal tubes through the other incisions. The surgeon will put carbon dioxide inside you to lift the wall of the abdomen away from the organs. They will then use surgical clips to close off the ducts and arteries leading to the gallbladder and remove the gallbladder with instruments inserted through the tubes.

After the gallbladder has been removed, the carbon dioxide is allowed to escape before the incisions are stitched or closed with staples. The clips will stay inside you.

If your gallbladder is very inflamed you may need 'open cholecystectomy', which requires a larger cut in your upper abdomen.

What can I expect after the procedure?

You will be monitored in recovery for some time and will normally be able to go home within 24 hours. You may have some side effects from the general anaesthetic such as a headache, nausea or vomiting, which can be controlled with medicine.

You will have some pain in your abdomen after the operation, which can be controlled using pain relief. You may also have some pain in your shoulder from the gas used in the operation, which can be eased with walking.

You will have a drip in your arm at first, which will be removed after the anaesthetic wears off. You can take sips of water at first then slowly get back to eating and drinking normally.

Your wounds will have clips or stitches and you may also have a drain in your side to allow fluid to leave your body. This is usually removed the next day. Make sure you keep your wounds clean.

You will be tired at first. Do not drive for the first 7 days, smoke or lift heavy weights. You can expect to recover fully and return to your normal activities within 2 weeks.

Contact your doctor immediately if you have:

• a lot of discharge from the wounds
• a fever
• pain that can't be controlled by pain relief medicine
• swelling, tenderness or redness in the abdomen
• yellow eyes or skin

What are the risks of a cholecystectomy?

A cholecystectomy is a very safe procedure. As with all surgery, however, there is a very small risk of complications, which include:

• leaking bile
• bleeding
• blood clots
• heart problems
• infection
• injury of other organs
• pancreatitis
• pneumonia