You'll need to have a preoperative assessment in hospital during the weeks leading up to your gallbladder removal surgery (cholecystectomy).
During this appointment:
- you may have some blood tests and a general health check to make sure you're fit for surgery and determine whether a keyhole or open procedure is most suitable for you
- you can discuss any concerns or ask any questions about your operation
- you'll be advised about things you can do to reduce your risk of problems after surgery, such as stopping smoking
- you'll be told about when you need to stop eating and drinking before your operation – this will usually be from the night before
There are 2 main ways gallbladder removal surgery can be performed:
- laparoscopic (keyhole) surgery – several small cuts (incisions) are made in your tummy (abdomen) to access and remove your gallbladder
- open surgery – a single larger incision is made in your tummy to access and remove your gallbladder
Both procedures are performed under general anaesthetic (where you're asleep) and both are equally effective.
But keyhole surgery tends to be carried out whenever possible because you can leave hospital sooner, recover faster and are left with smaller scars.
During keyhole gallbladder removal surgery:
- a small incision (about 2 to 3cm) is made by your belly button and 2 or 3 smaller incisions (about 1cm or less) are made on the right side of your tummy
- a small tube is inserted into 1 of the incisions and carbon dioxide gas is pumped into your tummy, inflating the abdomen to make it easier for your surgeon to access your gallbladder
- a laparoscope (a long, thin telescope with a light and camera at the end) is inserted through the larger incision, which allows your surgeon to see inside your tummy on a monitor
- special surgical instruments are inserted through the other incisions and are used to remove your gallbladder
- the gas is released from your tummy, and the incisions are closed with stitches and covered with dressings
You can usually go home later the same day. Recovery typically takes about 2 weeks.
An open procedure may be recommended if you can't have keyhole surgery – for example, because you have a lot of scar tissue from previous surgery on your tummy.
It's also sometimes necessary to turn a keyhole procedure into an open one during the operation if your surgeon is unable to see your gallbladder clearly or remove it safely.
Your surgeon can explain why they feel an open procedure is best for you. If you're due to have keyhole surgery, the risk of it becoming an open procedure should be discussed beforehand.
During open gallbladder removal surgery:
- a larger incision (about 10 to 20cm) is made in your tummy, underneath your ribs
- surgical instruments are used to remove your gallbladder
- the incision is closed with stitches and covered with a dressing
You'll usually need to stay in hospital for a few days afterwards.
Recovery typically takes 6 to 8 weeks.