Before, During, and After Gallbladder Surgery
The purpose of the gallbladder is to aid the digestion of food. The bile helps dissolve fat so that it can be absorbed into the bloodstream to provide nutrients to the body. The gallbladder stores bile, which is made in the liver for use in the digestion of food. Food, particularly fatty foods, trigger the release of bile from the gallbladder.
Symptoms of gallbladder problems include:
- Bloating after eating
- Fatty food intolerance
- Back pain
- Feeling of fullness
- Clay-colored stool
- Pain under the right arm
Gallbladder (gallstone) attacks, which can be very painful, typically happen when a gallstone prevents bile from moving out of the gallbladder. They can even be mistaken for a heart attack, and vice versa. Never ignore symptoms that could be a heart attack, including left arm pain and chest pain.Testing to confirm that the problem is indeed a gallbladder issue may include:
- Blood tests, including amylase, lipase, complete blood count (CBC) and liver function tests
- Abdominal ultrasound
- Radionuclide scan
- Abdominal CT scan
In most cases, the surgery is scheduled in advance, but in cases of severe inflammation, a gallbladder surgery may be performed urgently after diagnosis. Testing for gallbladder disease includes a physical exam, blood tests, and possible abdominal imaging that can detect the presence of gallstones and blockages.An ERCP, or endoscopic retrograde cholangiopancreatography, is a less invasive procedure to treat gallstones, may or may not be performed prior to scheduling surgery. The decision is made based on the size and number of gallstones, and the condition of the gallbladder.
1 What to Eat Before Gallbladder Removal Surgery
Avoiding fatty foods can help prevent gallbladder “attacks”—gallbladder pain in individuals with gallbladder disease—as these foods are known to increase secretions from the gallbladder which in turns leads to discomfort. Fried foods, greasy foods and other types of food that contain elevated levels of fat should be avoided by people who are having gallbladder issues. Many sources indicate that eggs should also be avoided.Another common trigger for gallbladder pain is eating foods that you are sensitive to or cause an allergic reaction. For example, many people have a sensitivity to dairy products, but the symptoms are mild (a runny nose, stomach upset) so they continue to eat foods containing dairy. For these people, the foods that they are allergic to are much more likely than other foods to trigger significant gallbladder pain and should be avoided. Dairy is just one example. For some it may be gluten, for others, it may be something entirely different.If there is a food in your diet that routinely causes symptoms of sensitivity such as bloating, gas or stomach upset, it will be more likely than other foods to cause a gallbladder attack. In general, a diet rich in fruits and vegetables, low in fat and meat is ideal.
General anesthesia is used during gallbladder surgery. The surgery begins with the administration of an IV sedative to relax the patient. Once the drug takes effect, the anesthesia provider inserts a breathing tube, or endotracheal tube, through the patient’s mouth into the windpipe.Once the breathing tube is in place, drugs are given to make the patient sleep and treat/prevent pain. The tube is then connected to a ventilator to provide air to the patient’s lungs during the procedure.During the procedure, the anesthesiologist constantly monitors the vital signs of the patient and provides any necessary medications.
3 The Procedure
The most common technique used for gallbladder surgery is the laparoscopic approach, which uses a camera and a few small incisions to visualize the surgery, instead of a large incision. The laparoscopic method has become the “gold standard;” however, the surgery can be converted to the “open” procedure quickly if the surgeon deems it necessary or if complications arise.The surgeon begins with four small incisions, approximately half an inch long, in the upper right side of the abdomen. Two of these incisions allow the surgeon to place surgical instruments in the abdominal cavity. The third incision is used to insert the laparoscope, an instrument that has a light and a video camera that allows the surgeon to view the surgery on a monitor while working. The fourth incision is used to insert a port that releases carbon dioxide gas, inflating the abdomen to allow better visualization and more room to work.
The gallbladder is separated from the healthy tissue and is placed in a sterile bag to allow it to pass through one of the small incisions. If the gallbladder is enlarged or hardened, and cannot fit through the laparoscopic incisions, the surgery is converted to an open procedure to allow removal of the tissue.The surgeon then inspects the area where the gallbladder was removed and closes the ducts that were connected to it. If there are no signs of leaking or infection, the port that blows carbon dioxide into the abdomen is removed and the remaining gas leaks out of the incisions as the instruments are removed. The incisions are then closed with staples, stitches, or adhesive bandages.
4 After Gallbladder Surgery
After gallbladder surgery is finished, the patient is allowed to slowly wake, and the breathing tube is removed. The patient is then transported to the Post-Anesthesia Care Unit for monitoring while the anesthesia drugs completely wear off.During this phase of recovery, the patient will be closely watched by the staff for signs of pain, changes in vital signs or any complications from surgery. If no complications are observed and the patient is awake, they can be transferred to a hospital room an hour or two after surgery.During the day after surgery, the patient is observed for signs of complications, including infection, bleeding, and the leakage of bile, a rare but serious condition that requires a second surgery to correct. Blood is also drawn and analyzed to help monitor the patient’s health.
Most patients are able to go home within 24 hours of surgery to continue recovering from surgery and return to their normal daily activities in less than a week. More strenuous activity may require a longer healing time.A small percentage of patients require a low-fat, high-fiber diet in the first few weeks after surgery to prevent discomfort and diarrhea after eating. If diarrhea persists despite dietary changes, the surgeon should be notified. This complication is not uncommon but can pose serious issues if it continues after recovery.The surgical incisions require minimal care and can be cleaned with soap and water during a shower. If the incision was closed with adhesive bandages, they will fall off on their own or can be removed by the surgeon during an office visit. Any foul drainage or significant redness of the incisions should be reported.
A Word From VeryWell
Gallbladder pain is typically associated with pain in the hour after eating and is often moderate to severe in intensity. As a general rule, abdominal pain shouldn’t be ignored, whether the gallbladder is the suspected source or not.If you think you are having gallbladder attacks, seek medical treatment rather than ignoring it and hoping it will go away. The pain can worsen over time.