What is a cholecystectomy?

Cholecystectomy is a surgery to remove your gallbladder.

Your gallbladder is a small organ that sits below your liver on the right side of your abdomen (tummy). It collects and stores bile — a liquid made by the body that helps digest food.

Gallbladder removal can be done in 2 ways:

1. Laparoscopic cholecystectomy — keyhole surgery.
2. Open cholecystectomy — open surgery through a cut in your abdomen.

Keyhole surgery is more common as it is less invasive. This means it involves smaller cuts and usually leads to a faster recovery. Open cholecystectomy is used for gallbladders that are hard to remove, or if the keyhole surgery becomes difficult.

What are the benefits of a cholecystectomy?

Your doctor may recommend having your gallbladder removed if you have gallstones that are causing problems. Gallstones are small, hard stones that can form in your gallbladder.

Most people don't have any symptoms with gallstones. But sometimes, gallstones can move into your bile ducts. These are tubes that carry bile from your liver to your gallbladder, and from your gallbladder to your small intestine. When this happens, gallstones can cause symptoms such as:

• abdominal (tummy) pain
• pain in your back or your right shoulder
• nausea and vomiting

Other complications of gallstones include:

• cholecystitis (inflammation of the gallbladder)
• pancreatitis (inflammation of the pancreas)
• jaundice
• infection of the bile ducts

A cholecystectomy and exploration of the bile duct is a surgical procedure to remove your gallbladder, as well as any stones found in your bile duct.

Another reason for having a cholecystectomy is to treat gallbladder cancer. If you have gallbladder cancer, your doctor may also remove some surrounding tissue.

What does a cholecystectomy involve?

General anaesthetic is usually used for a cholecystectomy. This means you will have medicines to make you sleep so you don't feel pain during the surgery.

Most people who have their gallbladder removed have a laparoscopic cholecystectomy (keyhole surgery). Some people need to have an open cholecystectomy, which involves a larger cut in your upper abdomen.

For laparoscopic surgery to remove your gallbladder, your surgeon will make up to 4 small incisions (cuts) in your abdomen.

A small amount of carbon dioxide gas is pumped into your abdomen through one of the cuts. The gas lifts the wall of your abdomen away from your organs. It helps your surgeon to see what they are doing.

They will insert a laparoscope (instrument with a light and camera) into one of the cuts to see inside your abdomen. Surgical tools to remove your gallbladder are inserted through the other cuts.

After your gallbladder is removed, the carbon dioxide is allowed to escape. Then the cuts are stitched or closed with staples.

How can I prepare myself for a cholecystectomy?

Before a cholecystectomy, your surgeon will discuss with you if you need to stop taking any medicines or supplements. You will be asked not to eat or drink for several hours before your surgery.

Make sure you follow all the instructions from your doctor.

How soon will I recover?

After having your gallbladder removed, your health team will monitor your recovery. You may have some side effects from the general anaesthetic, such as nausea or vomiting, which can be managed with medicine.

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

• pain-relief medicines
• heat packs
• moving and walking around

You will have a drip (a small tube to help give you medicines and fluids) in your arm at first, which will stay until after the anaesthetic wears off. You can take sips of water then slowly return to eating and drinking normally.

You may need to stay in hospital for around 24 hours after a laparoscopic cholecystectomy. Sometimes the cholecystectomy can be a day procedure and you can go home that night. A longer hospital stay is needed after an open procedure.

Recovery at home will depend on the procedure you had. After a laparoscopic cholecystectomy, you can expect to return to your normal activities within 1 to 2 weeks.

You may feel tired for several weeks after your surgery. Don't lift anything heavier than 3 to 5 kilos and avoid excessive activity while you are recovering. This is usually for at least 2 weeks — ask your surgeon to explain what you can and can't do in your situation.

Your wounds will have clips or stitches. Make sure you keep your wounds clean and follow your doctor's instructions.

If you had open surgery, it may be because your situation is more complex. Ask your health team about your recovery, including what you can and can't do once you're home from hospital.

What complications can happen?

A cholecystectomy is generally a safe procedure. As with all surgery, there is a small risk of complications.

General complications of surgery can include:

• a reaction to the anaesthetic
• bleeding
• infection
• blood clots

Possible complications of gallbladder surgery include:

• injury of nearby organs
• leaking bile into your abdomen
• pancreatitis
• pneumonia

Contact your doctor immediately if you have:

• discharge from your wound(s)
• fever
• pain that is not controlled by pain-relief medicines
• yellow eyes or skin
• nausea and vomiting that is not improving

Are there alternatives to a cholecystectomy?

Gallbladder removal is the usual treatment for gallstones. Doctors recommend it as the best treatment for most people with painful gallstones.

There are medicines that can dissolve gallstones. Medicines have been used alone or with lithotripsy — a treatment that uses sound waves to shatter gallstones. Small gallstones can then travel through the body more easily.

Sometimes your doctor may recommend surgery to add stents (small straight tubes) into the bile ducts to help the gallstones travel through.

These treatments are rarely recommended because:

• they do not always work
• they can cause side effects
• new gallstones often form after treatment

What will happen if I decide not to have the procedure or it is delayed?

Depending on your symptoms, your doctor will advise you when to have surgery. You may be able to choose elective surgery if your symptoms are less severe. This allows your gallbladder to become less swollen and easier to operate on.

An emergency cholecystectomy should happen as soon as possible. Delays in surgery can cause more complications after surgery and you may have to stay in the hospital for longer.

Resources and support

Read more on preparing for surgery.

The Gastroenterological Society of Australia (GESA) has information on gallstones and cholecystectomy.

The Agency for Clinical Innovation also has a helpful fact sheet on symptoms, causes and treatment of gallstones.

To read more on gallstones and gallbladder removal visit the healthdirect pages on:

• gallstones
• laparoscopic cholecystectomy
• open cholecystectomy
• cholecystectomy and exploration of the bile duct

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

The NSW government has fact sheets on gallstone management in several community languages.

Health Translations Victoria has information on your surgical journey in different community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Find an Aboriginal Community Controlled Health Organisation (ACCHO) or Affiliate near you.