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Laparoscopic Cholecystectomy

AMBULATORY CARE:

What you need to know about a laparoscopic cholecystectomy:

Laparoscopic cholecystectomy is surgery to remove gallstones and your gallbladder.

Gallbladder

How to prepare for surgery:

  • Your surgeon will tell you how to prepare. You may be told not to eat or drink anything after midnight on the day of surgery. Arrange to have someone drive you home after surgery and stay with you for 24 hours.
  • Tell your surgeon all the medicines you currently take. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
  • You may need blood or urine tests. You may also need x-rays, an ultrasound, or a CT scan. Tell your surgeon if you had an allergic reaction to contrast liquid. Tell your surgeon about any allergies you have, including medicines and anesthesia.

What will happen during surgery:

  • Your surgeon will make between 1 and 4 small incisions in your abdomen or belly button. He or she will insert small tools into the incisions. Your abdomen will be filled with carbon dioxide gas to make it swell. This helps your surgeon see your organs better and gives more room to move the tools around.
    Laparoscopic Surgery
  • Your surgeon will look for and remove gallstones in and around your gallbladder. X-rays or an ultrasound may be used. Your surgeon will remove your gallbladder through one of the incisions. The carbon dioxide will be released from your abdomen. The incisions will be closed with stitches, medical glue, or adhesive strips, then covered with bandages.

What to expect after surgery:

You will be taken to a recovery room until you are fully awake. Healthcare providers will monitor you closely for any problems. Providers will help you walk around to prevent blood clots. You may be able to go home later the same day, or you may stay in the hospital overnight.

  • Pain, a sore throat, nausea, and vomiting are common after this surgery. These should get better within a few days. You may also have diarrhea that lasts up to a few months.
  • Medicines may be given to prevent or treat pain, nausea, and vomiting. Medicines may also be given to prevent a bacterial infection. Blood thinners may be given to prevent blood clots. You may be bleed or bruise more easily while you are taking blood thinners.
  • Your surgeon will tell you when to remove the bandages covering the surgery area. He or she will tell you when it is okay to start bathing. You may need to take showers instead of baths for a few days.
  • Your surgeon will tell you when you can drive, return to work, and do your regular daily activities.
  • You will be shown how to care for the surgery area and check for signs of infection. You will also be told which foods to eat in the days and weeks after surgery.

Risks of a laparoscopic cholecystectomy:

  • You could bleed more than expected or get an infection. Any carbon dioxide gas still in your body can cause neck and shoulder pain. Your gallbladder may leak bile into your abdomen during or after surgery. This can cause a severe infection or an abscess.
  • You may still have gallstones after surgery. You may need a different procedure to remove them. Your surgeon may need to make a larger incision than expected during surgery. Your bile duct, bowel, or other organs could be damaged during surgery. This can be life-threatening.

Call your local emergency number (911 in the US) if:

  • You feel lightheaded, short of breath, and have chest pain.
  • You cough up blood.

Seek care immediately if:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You cannot stop vomiting.
  • Your bowel movements are black or bloody.
  • You have pain in your abdomen and it is swollen or hard.
  • You have a fever over 101°F (38°C) or chills.

Call your doctor or surgeon if:

  • You have pain or nausea that is not relieved by medicine.
  • You have redness and swelling around your incision sites.
  • You have blood or pus leaking from your incision sites.
  • You are constipated, have diarrhea, or your bowel movements are pale.
  • Your skin or eyes are yellow.
  • You have questions or concerns about your surgery, condition, or care.

Medicines:

You may need any of the following:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Take deep breaths and cough 10 times each hour:

This will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Then let the air out and cough strongly. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath. Then let the air out and cough. Repeat these steps 10 times every hour.

How to use and Incentive Spirometer

Care for the surgery area:

  • Remove the bandages as directed. Your surgeon may tell you to remove the bandages the day after surgery.
  • Keep the area clean and dry. You may take a shower the day after your surgery. Do not take baths, swim, or soak in a hot tub until your surgeon says it is okay.
  • Check for signs of infection each day. Check the area for swelling, red streaks, or pus. Tell your surgeon right away if you see any of these.
  • Hug a pillow against the surgery area before you sneeze or cough. This will help prevent pain and protect the surgery area.

What to eat after surgery:

  • Eat low-fat foods for 4 to 6 weeks while your body learns to digest fat without a gallbladder. Slowly increase the amount of fat that you eat.
  • Drink more liquids. Ask how much liquid to drink and which liquids are best for you.

When to return to work and other activities:

  • Rest often and slowly increase your activity level each day. If an activity causes pain, wait several days before you do that activity again.
  • Do not drive for the first 24 hours after surgery. Your surgeon will tell you when it is okay to drive after the first 24 hours. This is usually after you have stopped taking narcotic pain medicine for a few days.
  • Do not lift anything heavier than 10 pounds for 4 to 6 weeks, or as directed.
  • You may return to work or other activities as soon as your pain is controlled and you feel comfortable. This is usually 5 to 7 days after surgery.

Follow up with your doctor or surgeon as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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