What is a cholecystectomy and common duct exploration?

Cholecystectomy is surgery to remove the gallbladder. The liver and gallbladder are part of your digestive system. The liver makes bile that helps your body break down the fat in food. Ducts carry bile from the liver to the gallbladder and small intestine. The gallbladder is a small sac under your liver on your right side that stores bile.

You may need a cholecystectomy if you have:

• Gallstones
• Swelling or an infection in your gallbladder
• Gallbladder disease
• Gallbladder cancer

How is cholecystectomy and common duct exploration done?

Before the procedure:

• Your healthcare provider will ask you to sign a consent form for the cholecystectomy and common duct exploration. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
• Tell your healthcare provider if you are allergic to any medicines.
• Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or illegal drugs (if any).
• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.

During the procedure:

• You will be given medicines to prevent pain during your surgery. These may include:
  • Regional anesthesia numbs part of your body while you stay awake. If you have regional anesthesia, you may also be given medicine to help you relax.
  • General anesthesia relaxes your muscles and puts you to sleep. A breathing tube is usually put in your throat when you have general anesthesia.
• Your surgeon will determine the best surgery for you. The type of surgery you have to remove the gallbladder may be one of the following:
  • Open cholecystectomy (laparotomy): Surgery to remove the gallbladder and part of the tube from the gallbladder to the common bile duct through one larger cut in your upper belly
  • Laparoscopic cholecystectomy: Surgery to remove the gallbladder through several small cuts in the upper belly. Your healthcare provider inserts a lighted tube with a camera (called a laparoscope) through the cut and into your belly to help see and remove the gallbladder.
• If there is any question that stones may be in the common bile duct, the surgeon will place a T-tube in the common duct. A T-tube is a catheter used to explore and drain the common duct. The tube may be left in place and an X-ray (cholangiogram) may be done 7 or 8 days after surgery. If more stones are found, a radiologist can remove them without you going back to surgery.
• Your surgeon will close cuts made in your belly with sutures (stitches), staples, or Steri-Strips.
• If you have an infection, temporary tubes may be left to drain blood and fluid for a few days after surgery.
• Gallstones may also be removed by a procedure called endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a procedure in which a slim, lighted tube with a camera (called an endoscope) is passed through the stomach and into the small intestine and bile duct to check for stones or blockages. ERCP may be used in combination with a laparoscopic surgery to enlarge the opening from the common bile duct into the intestine. It may then be possible to remove the stones or allow them to pass through the enlarged opening

What happens after the procedure?

• You may stay in the hospital for a few hours or several days to recover, depending on your condition.
• While you are in the hospital:
  • You will be checked often by nursing staff.
  • Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
  • Your heart rate, blood pressure, and temperature will be checked regularly.
  • Your surgery site will be checked often and dressings may be changed if necessary.
• For the first day or so after surgery, you may not be given anything to eat or drink. Then you will be allowed to have small amounts of water, later clear liquids, and then some solid food until you are able to have a regular diet.
• Your provider may prescribe medicine or other therapy to:
  • Treat pain
  • Treat or prevent an infection
  • Treat or prevent side effects, such as nausea or constipation, from other treatments
  • Dissolve gallstones

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Bloating or pain in your belly
  • Nausea or vomiting
  • Yellow skin or eyes
  • Light colored bowel movements
  • Dark urine
  • Diarrhea, constipation, or other intestinal problems
  • Redness, swelling, pain, warmth, or drainage from your surgical wound
  • Fever, chills, or muscle aches.
• Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many things, including your general health, why you are in the hospital, and the treatment you need. The average amount of time to stay in the hospital after a cholecystectomy is 3 to 5 days. Talk with your provider about how long your stay may be.