Is gallstone surgery painful? What precautions should be taken after the surgery?

Overview

A gallstone surgery also known as cholecystectomy is a surgical procedure to remove the gallbladder.

A gallbladder is a small, pear-shaped organ that is located under the liver on the right upper side of the abdomen.

The gallbladder collects and stores bile. Bile is produced in the liver.

A gallbladder or gallstone surgery is done when the bile solidifies into crystals, obstructs the bile ducts, and causes infection or inflammation of the gallbladder or other organs in the biliary system.

It can cause health problems like pancreatitis (inflammation of the pancreas), jaundice, acute cholangitis (bile ducts are infected), or most commonly cholecystitis (gallbladder infection and inflammation).

Gallstones can cause serious health problems like excruciating pain in the abdomen and back along with other symptoms like nausea, vomiting, and high fever. This condition is called gallbladder attack and needs immediate medical attention.

A cholecystectomy is a safe and common surgery done to relieve the symptoms and remove the gallbladder. It is mostly done by a laparoscopic procedure through small incisions.

In laparoscopic cholecystectomy, the person can usually go home after a few hours and does not need a hospital stay.

In certain cases, an open cholecystectomy is done where a big incision is made in the abdomen. It is done when a laparoscopic procedure cannot be performed or there are other complications.

What is cholecystectomy?

The best way to treat gallstones is to remove the gallbladder. This surgical procedure is called cholecystectomy.

Medications or alternative therapy are used to break up and dissolve the gallstones, but they give temporary relief. Surgery is the only way to remove the gallbladder permanently and stop the reoccurrence of gallstones.

Cholecystectomy or gallstones surgery is recommended if:

• If there are gallstones (cholelithiasis)
• Infected or inflamed gallbladder (cholecystitis)
• Pancreas inflammation (pancreatitis)
• Presence of gallstones in the bile ducts (choledocholithiasis)
• Gallbladder cancer

Cholecystectomy is of two types:

Traditional or open cholecystectomy

An incision of 4 to 6 inches is made in the upper-right side of the abdomen. The surgeon then removes the gallbladder through the incision.

Sometimes drains are used to remove fluids and pus from the abdomen.

Laparoscopic cholecystectomy

In this procedure, 3 to 4 small incisions are made in the abdomen. The surgeon inserts a thin tube with a camera called a laparoscope. Other surgical tools are also inserted through the incisions. The operation is projected on a TV monitor.

The abdomen is inflated with air or carbon dioxide to view the inside of the abdomen properly. The surgeon then carefully removes the gallbladder through one incision.

Preparing for a cholecystectomy

The doctor and the healthcare provider will explain the procedure in detail.

Preparing for a gallbladder removal:

• The healthcare provider will take note of the past medical history and medications
• The doctor and the medical team should be informed about pregnancy during consultancy
• Physical examination, blood tests, and other diagnostic tests are conducted
• Eating or drinking is prohibited 8 hours before the surgery
• Any allergy to medications or anesthesia (both local and general) should be informed
• A shower at night or the morning of the surgery preferably with an antibiotic soap
• Stop taking medications like blood thinners, antibiotics, vitamins, and supplements, or other medications
• Prescribed medications can be taken with just a sip of water after consulting the doctor
• Patients are advised to carry comfortable clothing, a toothbrush, or magazines for a night’s stay after a laparoscopic procedure.

Laparoscopic cholecystectomy needs a hospital stay for a few hours or an overnight stay. The patients must be accompanied by a guardian or relative to drive home after surgery.

Open cholecystectomy requires a hospital stay of 5 days to a week depending on the health condition of the patient.

Is gallstones surgery painful?

The laparoscopic procedure is done in an outpatient facility. Patients are discharged the same day or maybe recommended an overnight stay.

During the stay, patients are taken to the recovery room and are put under observation.

There is minimal pain after laparoscopic gallstone surgery. Patients may feel some pain in the abdomen. This is normal after a cholecystectomy. Some pain can be felt in the shoulder tips. This is due to the presence of gas that is used to inflate the abdomen. The pain will disappear after 1 or 2 days.

Sometimes, a thin plastic tube is inserted through the nose into the stomach to remove the gas or air from the abdomen. Patients are not allowed to eat or drink anything until the tube is removed.

The pain usually lasts for 24 to 48 hours.

Doctors prescribe pain medications to ease pain. Ice packs on the incision site can also help with the pain.

Pain medications can be taken during the first few days after surgery.

Some patients may experience some nausea and vomiting due to the anesthesia. This will be better after one or two days. Patients must seek medical care if there is frequent vomiting or nausea.

How is recovery different in laparoscopic cholecystectomy and open surgery?

Recovery is quicker in laparoscopic cholecystectomy.

Open cholecystectomy is a major surgery and needs a hospital stay. Patients experience more pain in the incision site compared to laparoscopic surgery which is a minimally invasive procedure.

In open surgery, patients will require intravenous for a few days until they can tolerate foods and fluids.

Patients can resume normal activities after 6-8 weeks. In laparoscopic surgery, patients can resume normal daily activities within two weeks.

What precautions should be taken after surgery?

At home, it is necessary to take precautions and keep the incision site(s) dry, clean, and free from infections.

The following activities are recommended:

Wound care

Keep the surgical site clean and dry. Follow instructions on when to remove and replace bandages and wound care.

After the dressings are removed, patients can take a shower a day after the procedure (laparoscopic).

If there are Steri-strips, cover them with plastic while taking a shower in the first week. Do not apply water or try to dry the Steri-strips. They will fall off when they are dry.

Avoid swimming or soaking in a bathtub.

Diet instructions

Eat easy-to-digest healthy foods. After surgery, the doctor recommends having clear soups and fluids.

In the first week, split daily meals into small mini meals for easy digestion. Individuals can resume a normal diet after abdominal bloating and discomfort subside.

Avoid skipping meals or late dinners at night.

Include fresh vegetables, fruits, and fiber-rich food in the diet. Avoid fatty, greasy, or spicy foods.

Minimize the intake of caffeine or tea.

Physical activities

Individuals should resume daily activities soon after the surgery.

Avoid lying in bed and sit straight and slowly try walking around the house. This helps in blood circulation and prevents blood clots.

Do simple leg exercises like ankle rotation, knee lifts, leg stretching, etc. for improved blood circulation.

Avoid strenuous activities, exercises, or lifting of heavy objects for a few weeks.

Sleeping posture

Get sleep for at least 8 to 10 hours. This helps to recover early from the surgery.

Change position while sleeping to alleviate pain.

Try relaxing. Read good books, watch television, or listen to music. This relieves stress, and anxiety, and promotes sleep.

Stay away from triggers

Do not smoke or consume alcohol after surgery. Smoking can cause anesthesia complications.

Refrain from unhealthy food habits and diet.

Take care of mental health along with physical health for faster recovery.

Final words

Gallstone surgery is a very common and safe procedure. However, there is a possibility of developing complications post-surgery.

Complications may include:

• Loose stools
• Bleeding
• Wound site infection
• High fever
• Difficulty eating
• Breathing problems
• Indigestion
• Bloating and flatulence
• Pain (if it cannot be managed with pain medications)

If any of these symptoms arise, patients are encouraged to immediately call the doctor and seek medical help.

References