Â鶹ӳ»­

What happens during a cholecystectomy?

In general, there are two approaches to gallbladder removal surgery: minimally invasive or open. An open cholecystectomy requires a larger incision and has a longer recovery time. Minimally invasive surgeries are more common.

¡°Minimally invasive cholecystectomies are laparoscopic or robotic,¡± says Ledet. ¡°A robotic cholecystectomy is a laparoscopic procedure where we use a console to control a robot to perform the surgery. At MD Anderson, we prefer robotic cholecystectomies because they allow for better visualization, and there are devices and substances like indocyanine green we can use to make the procedure safer.¡± 

The procedure

A cholecystectomy is done in an operating room. You won¡¯t need to do any bowel prep. Your doctor will give you specific instructions on how to prepare for surgery.

You¡¯ll be placed under general anesthesia, so you¡¯ll be asleep during the procedure.

For laparoscopic and robotic cholecystectomies, first we pump carbon dioxide gas into your abdomen, so we can see your organs, Ledet explains. We make 4 or 5 small incisions (access ports) in your abdomen. If we¡¯re doing a laparoscopic cholecystectomy, we place our surgical tools in the ports to remove your gallbladder. If we¡¯re doing a robotic cholecystectomy, we attach the robotic arms to the ports and then place the surgical tools in.

Once the surgery is over, the tools are removed, and we release the gas from your belly. Then we close the incisions with dissolvable sutures and cover them with skin glue. 

How long will surgery last?

The length of your cholecystectomy can vary, depending on the condition of your abdomen and gallbladder and the expertise of your surgeon.

¡°If a patient hasn¡¯t had additional abdominal surgeries and doesn¡¯t have a lot of scar tissue and inflammation, I can do a robotic cholecystectomy in approximately one hour,¡± says Ledet. ¡°The total operating room time is approximately 90 minutes. This time reflects the additional 30 to 45 minutes to get patients into the operating room, administer anesthesia and dock the robot. More complex cases will have longer operating room times.¡±

Some patients can go home the same day after surgery; others may need to stay in the hospital for a few days.

How long does it take to recover from a cholecystectomy?

Your doctor will give you specific instructions to follow after your surgery.

After a laparoscopic cholecystectomy, you can expect to resume your normal activities in 1 to 2 weeks, though you may be a little sore, says Hodge. You should feel completely healed about 6 weeks after surgery. 

You should expect to stay in the hospital for 3 to 5 days after an open cholecystectomy, and it may take longer for you to fully recover and heal.

Will I have to make changes to my diet after a cholecystectomy?

While you¡¯re recovering, it¡¯s best to avoid fatty foods because they will be a little harder to digest initially, says Santos. About 1 in 4 people will develop diarrhea as a side effect after surgery, but it will go away over time. The reason the diarrhea goes away is that the main duct that connects to the intestines starts to grow after the gallbladder is removed. As it grows, you will start losing the urge to have diarrhea.

After you fully recover, there are no dietary restrictions. You can eat and drink like you would normally.

¡°Weight gain is common because once people heal from the surgery, they may start eating those fattier foods they¡¯d been avoiding initially,¡± says Santos. ¡°They no longer have that barrier preventing them from eating fatty foods.¡±

How will my body function after a cholecystectomy?

Ledet explains it to patients this way: Think of your gallbladder as the garage to your house. Your house is the liver, and that¡¯s where the bile is made. The gallbladder is the garage, which is where the bile is stored. You can live without a garage, but you can¡¯t live without a house. 

¡°Initially, you won¡¯t have that surge of bile available to help you digest fatty foods,¡± she says. ¡°Your body will have to adjust slowly to the amount of bile coming out of the liver instead of having a garage full of bile waiting. But there aren¡¯t any long-term differences in how your body will function.¡±

What are the risks of a cholecystectomy?

There is always a very small chance of complications after surgery, says Hodge. We discuss the risks of a cholecystectomy with each patient.

Standard surgery risks 

• Infection
• Bleeding
• Damage to surrounding organs and structures

Cholecystectomy-specific risks

• Bile leak from the liver: We often treat this by placing a drain and/or doing an endoscopic retrograde cholangiopancreatography (ERCP).
• Common bile duct injury: This happens when the bile duct is mistakenly cut or damaged during surgery. It is a serious complication that requires surgery to correct.

¡°There¡¯s also a 1 in 3 chance that there will be a gallstone remaining after a cholecystectomy,¡± adds Santos. ¡°If it gets stuck in a duct, it can cause jaundice, light-colored stool and dark-colored urine. We can treat this by doing an ERCP, where our gastrointestinal team inserts a scope with a camera in your mouth and cleans out your ducts.¡±

What else should we know about cholecystectomies?

Cholecystectomies are very common procedures. At MD Anderson, our surgeons are experienced in doing cholecystectomies in patients who are undergoing cancer treatment.

To be clear, gallbladder cancer is very rare, and cholecystectomies are not often used as curative treatment ¨C only when the cancer is early-stage and has not grown beyond the gallbladder, explains Santos.

¡°We do gallbladder removal surgeries on patients treated for any number of cancers. Some cancer treatments can affect the gallbladder or make patients more prone to infection because they¡¯re immunocompromised,¡± he says. ¡°At MD Anderson, we have the specialty equipment and expertise to treat patients with unique needs. We communicate with their oncologists about timing and treatment to make sure we¡¯re performing the surgery at the right time for each patient.¡±

 or call 1-877-632-6789.