The gallbladder is a small, pear-shaped non-vital organ beneath the liver on the right side of the abdomen. The gallbladder stores bile produced by the liver until it is used in the small intestine to help digest fatty foods. When bile cannot travel through the tubes leading to the small intestine (bile ducts) due to inflammation or infection, surgical removal of the gallbladder may be recommended. Laparoscopic gallbladder surgery, a cholecystectomy, is a procedure in which the gallbladder is removed through several small abdominal incisions. During the more invasive open cholecystectomy, the gallbladder is removed through one large incision. Both procedures are performed under general anesthesia in a hospital setting. Risks such as infection are rare, but do occur.
Precautions
Both exposing your body's organs to the air and inserting foreign objects into your body increase the risk of an infection. To help prevent the possibility of infection, antibiotics may be prescribed for several days prior to surgery. Antibiotics may also be supplied via IV prior to and during the course of the surgery itself. Additionally, sterilization of medical instruments, gowns and masks; thorough hand scrubbing; and shortened hospital stays all minimize exposure to bacteria and viruses that may cause an infection.
Initial Hospitalization
The laparoscopic gallbladder surgery procedure is generally performed on an outpatient basis. Patients usually remain in the hospital for several hours to ensure they tolerated the surgery well and there are no initial problems due to infection or adverse reactions to anesthesia. Discharge is later the same day with instructions for self-care and monitoring. Open cholecystectomy patients will remain in the hospital for up to six days for a longer period of monitoring and supervised recovery.
Pain
Some pain is normal after gallbladder surgery due to organs being shifted and gas entering the body during the surgery. Pain tolerance varies on an individual basis and is monitored with a comparative pain scale. Pain medications are supplied as needed, ranging from non-steroidal anti-inflammatory medications such as ibuprofen to narcotic pain relievers. Contact your health care provider if pain does not begin to subside after a few days, or if it begins to worsen. This could be indicative of remaining gallstones or some type of internal infection.
Pneumonia
Pneumonia, an inflammation of the lungs due to infection, occurs occasionally after any type of surgery, but most particularly abdominal surgery. It is the most common fatal infection acquired in a hospital. Pneumonia is characterized by shallow breathing and retention of mucous, and the ensuing impaired ability to cough while healing from the surgery itself. To keep your lungs functioning well and minimize the risk of pneumonia, your health care provider may have you perform deep breathing exercises or breathe into an incentive spirometer.
Incision Site
The incision from your gallbladder removal is generally closed with surgical staples, stitches or steri-strip adhesive skin closures. A follow-up appointment is then scheduled approximately a week to 10 days after the procedure to remove the staples or stitches, or to check on the progress of the steri-strips. It is important to keep the incision dry and clean to prevent infection until the sutures have fully healed. TAking a shower is usually permitted, but immersing the wound in water during a bath is not permitted while the wound is open. Change bandages as instructed in your discharge paperwork. Learn to recognize the difference between normal drainage and the type of pus-filled drainage that indicates the development of an infection. Contact your physician immediately if the drainage develops a yellow color and thicker consistency.
Bile Duct Injury
Bile ducts are tubes leading from the liver into the gallbladder and from the gallbladder into the small intestine. Surgical instruments occasionally cause injury to the bile ducts during gallbladder removal. Even a small nick in one of the ducts can cause bile leakage. If bile leaks into the abdomen, there is the possibility of developing a serious and painful infection. Contact your physician immediately if your pain does not subside after a few days or begins to worsen. Treatment for injured bile ducts varies depending on the location and nature of the injury, but typically involves pain management and antibiotics.
Pancreatitis
An additional risk of gallbladder surgery is the development of pancreatitis, inflammation of the pancreas, due to infection. Symptoms of pancreatitis include pain, fever, jaundice, nausea and vomiting. Treatment for pancreatitis involves restoring the body's electrolyte and fluid balance, and managing the resulting pain.
