Open Cholecystectomy - Procedure, Benefits & Recovery

1. Open gallstone or gallbladder surgery is medically known as cholecystectomy.
2. This surgical procedure usually involves the removal of the entire gallbladder because of recurring cases of gallstones or a severe inflammation or injury caused by them. 
3. Usually, open gallstone surgery is performed after trying non-surgical or laparoscopic procedures to remove the gallstones or the entire gallbladder.
4. Some people may also have specific health conditions that need an open gallbladder procedure.

 

Why Is Cholecystectomy Done?

The doctor may recommend a cholecystectomy if:

1. You have gallstones (solid lumps in your gall bladder)
2. Your gall bladder is infected, red, or swollen.
3. Your gall bladder is cancerous

 

When to See a Doctor?

You can consult your doctor if you experience the following symptoms:

1. Pain in the centre or on the right side of your upper belly 
2. Pain that gets worse after a heavy meal or is constant
3. Pain that you can feel in the tip of your right shoulder blade and your back
4. Feeling of fullness   
5. Nausea, fever, chills, and vomiting
6. Jaundice (yellow-looking skin)

What to Expect if You Delay Surgery?

If you delay surgery, then you can expect more severe outcomes, such as:

1. Continued pain
2. Worsening of symptoms
3. Infection or bursting of the gallbladder
4. Serious illness and possibly death
5. Extensive inflammation
6. Cirrhosis (a disease of the liver characterised by inflammation of the cells)

Risks of untreated gall stones include:

1. Acute cholecystitis (inflammation of the gallbladder)
2. Jaundice 
3. Inflammation (swelling, redness, and tenderness) of the pancrease

Acute Cholecystitis may have the following complications if not treated on time:

1. Advanced cholecystitis 
2. Gangrenous cholecystitis (blood flow to the gall bladder is cut off)
3. Empyema of the gall bladder (accumulation of pus)
4. Perforation of the gall bladder

Risks of Chronic Cholecystitis include:

1. Mechanical or physiological dysfunction of gall bladder
2. Acute biliary colic (pain in the abdomen)
3. A more severe form of cholecystitis that requires urgent medical assistance (acute cholecystitis).
4. Cholelithiasis (presence of gall stones in the biliary tract)

                                                                                                         

1.  Removing the gallbladder will stop the pain and treat the infection caused by gallstones. It can also stop gallstones from coming back.
2. If gallstones are not treated, pain and infection can get worse

There are many reasons why open gallstone surgery becomes necessary: 

1. The gallstones block or get lodged in the bile duct, causing a ‘gallbladder attack’. It results in sharp pain in the abdominal region. 
2. The gallbladder or bile duct is severely inflamed. 
3. The patient is currently in the third trimester of pregnancy or more. 
4. You have blood-related disorders like sickle cell anaemia or issues with clotting. 
5. You consume anticoagulants or blood thinners.

Open Gall Stone Procedure

1. The abdominal area is cleansed with a disinfectant. 
2. A 5-7 inch incision is made under the ribs on the right side of the abdomen. The incision is slanted or up-and-down depending upon the condition of the patient. 
3. Vitals are monitored throughout the surgery. 
4. The skin and tissue are pulled back, and the gallbladder is removed. 
5. The wound is closed with stitches.
6. The area is bandaged.
7. An open gallstone treatment is a traditional surgical procedure. The alternative is laparoscopic surgery or keyhole surgery, which is minimally invasive. The latter is performed using four small incisions through which special tools are inserted to remove the gallstones, or in some cases, the gallbladder. 
8. The surgical approach chosen depends upon the severity of the case or the patient’s current health condition.

An open gallstone treatment is a traditional surgical procedure. The alternative is laparoscopic surgery or keyhole surgery, which is minimally invasive. The latter is performed using four small incisions through which special tools are inserted to remove the gallstones, or in some cases, the gallbladder. 

The surgical approach chosen depends upon the severity of the case or the patient’s current health condition

What to expect before surgery?

1. Pre-anaesthetic checkup or pre-op check-up is performed, including blood work, EKG, HIDA scan, abdominal ultrasound, ERCP, and chest X-rays. 
2. After studying the medical history and check-up results, the patient is given clearance for surgery, and the surgery appointment is fixed. 
3. The type of anaesthesia is decided upon based on the patient's condition. 
4. The patient must fast for at least 4 hours before the surgery. 
5. Some medications they are currently consuming may also be temporarily stopped for this period. 
6. The surgical procedure, post-operative care, and formalities are discussed.  

What to expect on the day of surgery?

1. Consent formalities from the patient as well as the next of kin must be signed. 
2. The patient must shower, change into hospital clothing, remove all jewellery, dentures, etc. 
3. The abdominal region is shaved if required. 
4. The PAC clearance is confirmed.
5. Recommended medication must be consumed with a sip of water. 
6. Record of previous meals and diet is checked. 
7. Vitals are monitored.
8. The patient is shifted into the operation theatre. 

What to expect during surgery?

1. The patient is made to lie down on the operating table in a supine position. 
2. An IV is inserted to administer fluids.
3. General Anaesthesia is administered.
4. An incision is made on the upper right part of the abdomen to remove the gallbladder. 
5. The incision is stitched and dressed.
6. The entire procedure takes 1-2 hours, depending upon the patient's condition.  

1. The patient is shifted to the observation room to monitor vitals and the effect of anaesthesia. 
2. If the patient is stable, they are shifted to the ward. If not, they may be placed in the ICU for further observation. 
3. After open gallstone surgery, the patient may have to stay in the hospital for 2-4 days, depending upon the recovery. 
4. Medication and pain management procedures are administered during this time. 
5. Once the patient is stable, they are given detailed instructions about recovery and care and then discharged. 
6. The patient must continue the use of pain management medication and antibiotics. 
7. Follow a low-fat diet for the recommended period. Reduce the consumption of fibre and caffeine during the recovery period. 
8. Drink plenty of fluids. 
9. Avoid clothing that can rub against the wound. 
10. Ensure that you wash your hand before and after touching the affected area. 
11. Resume mild physical activities like walking as the body allows. Avoid stressful physical activity, particularly those that stress the abdominal muscles. 
12. The wound area must be kept clean and dry. Change of bandage as recommended. 
13. A patient may resume regular physical activity after 3-4 weeks of the surgery.
14. The first follow-up is usually after 2 weeks of the surgery. 
15. Dissolvable stitches are usually used to stitch the wound. If non-dissolvable stitches are used, they must be removed in 7-10 days of the surgery. 
16. The area is examined for any swelling or abnormality. Following this, the medication may be stopped or changed as required. 
17. The doctor will also advise the patient on recommended physical activities and when they can resume their normal lifestyle. 

When to consult a doctor?

There may be some situations when you may have to see the doctor before the recommended 2-week follow up: 

1. The is pain or swelling near the incision that seems to get worse 
2. You have a persistent fever above 101 degrees F
3. A foul-smelling discharge is noticed at the site of the wound
4. Vomiting or nausea 
5. Bleeding and pus around the wound
6. Breathing issues 
7. Unable to eat or drink or have a persistent cough
8. You notice a yellowish tinge in the eyes
9. The bowel is grey