Open gallbladder removal, also known as open cholecystectomy, is a surgical operation removing the gallbladder. The objective of the procedure is to offer permanent relief from gallbladder-related problems such as gallstones. During the surgery, a large incision is made in the abdomen and used to get to and remove the gallbladder.
The gallbladder is a small body part inside the liver whose main function is to store bile. As the liver produces bile (an essential substance that assists in breaking down fats), the gallbladder stores the excess and releases it when a person eats meals containing fats that need to be digested. But normal digestion is possible even in the absence of a gallbladder. Your small intestines will still be receiving bile, except that your gallbladder won’t be there to store it.
Although laparoscopic (minimally-invasive removal) surgery is the most common gallbladder removal surgical operation, open gallbladder operations continue to be performed on different patients, particularly those who have scar tissue or other problems arising from abdominal surgical operations they’ve previously received.
Reasons for performing Open Gallbladder Removal
Most of the time, the gallbladder isn’t the most efficient body organ. The bile in it can be very dense and block the channels through which bile normally empties. The gallbladder can also be affected by gallstones, deposits of hard substance found in bile that can get trapped in the gallbladder. A gallstone can be as small as a sand grain or as large as a golf ball. Gallstone disease, known as cholelithiasis, can lead to temporary or long-term abdominal pain. Gallstones can also lead to the formation of infections that in turn cause nausea, vomiting, bloating, and increased pain. A surgeon usually removes a gallbladder if the patient is experiencing pain or other complications as a result of gallstones.
A gallbladder can also be removed if:
- it has a defect preventing it from emptying or filling properly
- gallstones are present in the common bile duct, blocking the duct and hindering gallbladder drainage
- the gallbladder is inflamed
- the pancreas is inflamed
You doctor may recommend the removal of your gallbladder if it is leading to acute, severe issues or has become a chronic problem, and you have the following symptoms:
- Sharp pain in your upper abdomen that can spread to your back, right shoulder, or middle part of your stomach
- Extreme body temperatures
- Jaundice due to duct blockage
Your doctor may advise waiting a bit to see whether the symptoms associated with your gallbladder become less severe. Changes in your diet such as reduced fat intake can also help. But surgery will likely be recommended if the symptoms don’t improve.
If it's possible, your doctor will likely recommend laparoscopic surgery rather than traditional open surgery, since the former is less invasive and recovery time is shorter. Nevertheless, an open surgery is the better option when specific complications are present, like if the gallbladder is severely troubled. The removal of a severely diseased gallbladder can be a complex task since the surrounding areas may also be affected, making laparoscopic surgery difficult.
It is also possible for a surgeon to fail to remove the gallbladder using the laparoscopic method and switch to the open method to completely and safely remove the organ
Risks Associated with Open Gallbladder Removal
Open gallbladder removal is seen as a safe surgical operation that rarely causes complications. Before the commencement of the operation, the doctor does a complete physical assessment as well as medical history to reduce the risks. The following are some of the risks related to gallbladder removal:
- allergies to anesthesia or other medication
- too much bleeding
- clotting of blood
- damaged blood vessels
- heart issues like a fast heart rate
- injured small intestine or bile duct
- inflamed pancreas
Your surgeon will let you know about all these risks and give you an opportunity to ask questions regarding the procedure before you decide to undergo it.
Preparations for Open Gallbladder Removal
Your doctor will have a few tests done on you before the operation to ensure that your health is good enough to withstand and recover well from the surgery. Some of these tests include an imaging scan of your gallbladder and a blood test. The doctor will also require a record of your medical history and a comprehensive physical examination.
Bring to your doctor's attention any drugs you're taking, including over-the-counter medication and nutritional supplements. You ought to also let your doctor know if you are or might be pregnant.
Your doctor will then tell you how to get ready for the procedure. Instructions may include having you:
- plan to have a person who will stay with you after the surgery and drive you home
- drink a prescribed solution for flushing out the bowels
- avoid eating or drinking anything for at least prior to the surgical operation.
- plan to stay in hospital in case complications arise planning for a hospital stay in case of complications
- use antiseptic soap while showering
On the day of the surgery, you’ll be asked to wear special hospital attire. A medical technician will insert an intravenous (IV) line in a vein in your arm through which an anesthesia specialist will administer general anesthesia, which will make you unconscious.
The skin over your stomach will be cleansed with an antiseptic solution to minimize the risks of infection. Then, your surgeon will make a slanted cut in your stomach’s right side, just below the ribs, or may make a vertical cut on your stomach’s upper area.
The surgeon will pull your muscle, skin, and other tissues for a better view of and access to your gallbladder. Your gallbladder will then be removed and the wound will be stitched closed. The surgery site will thereafter be bandaged. Although the time each method takes depends on how badly the gallbladder is diseased, laparoscopic gallbladder removal normally takes about ninety minutes, while open surgery usually takes longer.
What to Expect After the Surgery
After the operation, you’ll be taken to a hospital room where your vital signs will be continuously monitored. You will then be discharged from the hospital if the signs are all right.
You’ll stay longer in the hospital if you've an open procedure. Your physician will check whether you’re feeling a lot of pain or bleeding too much. The doctor will check for fever and whether your surgical area has leakage, both of which may be signs of infection.
You’ll stay in the hospital for a maximum of three days after an open surgery. You will take around four to six weeks to recover fully from an open gallbladder operation.
You can avoid complications after the operation by:
- walking around regularly
- drinking a lot of fluids
- avoiding lifting objects weighing over ten pounds for four to six weeks
- cleansing your hands prior to and after touching your surgical site
- following directions prescribed while changing the bandages
- avoiding putting on tight clothes
You can expect to experience slight to moderate pain following the operation, but the pain shouldn’t be severe. Your doctor may prescribe a stool softener to treat constipation that may be caused by the pain-relieving drugs. Foods high in fiber such as fruits and vegetables may also help in the smooth passage of stools.
You are not likely to develop complications following the operation, but you should contact your doctor if experience:
- worsening or persistent pain
- fever exceeding 101°F
- persistent vomiting
- the incision site’s discharge being bloody or having a bad smell
- a markedly red or swollen incision
- not passing stools for 2 or 3 days following the operation