Laparoscopic Cholecystectomy: What To Expect Before & After Surgery

Laparoscopic cholecystectomy involves removing the gallbladder through a 4 small incisions in the abdomen. A thin camera (laparoscope) and surgical instruments are inserted to operate while the surgeon watches the inside of the abdomen on a screen.

Key points:

• The gallbladder is removed completely, preventing future gallstone problems.
• Small incisions, local anaesthetic in the wounds and abdominal cavity mean much less pain and reduced scarring compared to traditional open surgery. Most patients are able to go home on the day of surgery. Most patients will not need strong opioid pain killers after surgery.
• The modern laparoscopic procedure means conversion to open surgery is extremely rare.

Historically, gallbladder removal required a large incision under the ribs. This method, called open cholecystectomy, caused significant discomfort and a 5 -7 day stay in hospital. Pneumonia and leg clots were much more common. Bile duct injuries, requiring major reconstructive surgery, were all too common. Late complications of adhesions and incisional hernia were a significant problem.

Main differences include:

• Pain and risks: Modern lap chole often involves no post-op pain due to the use of local anaesthetic in the wounds before skin incision. Improved understanding of bile duct injuries in the past has developed strict ‘rules of safety’ for modern day lap chole. Bile duct injuries are now, in the hands of well trained and attentive surgeons, largely avoidable.
• Hospital stay: Laparoscopic surgery is usually done as a day case.
• Recovery time: Laparoscopic chole now results in return to normal activities in 1-2 weeks. Heavy lifting should be avoided for 4 weeks to minimize the risk of wound hernia at the umbilical wound.

Preparation is an important stage in any operation. Before a laparoscopic cholecystectomy, patients usually undergo several checks and discussions with their surgical team.

Common steps include:

• Medical assessment: Blood tests and imaging studies may be required to help confirm suitability and fitness for surgery.
• Medication adjustments: Patients may be advised to stop certain medicines, such as blood thinners and SGLT-2 diabetes medicines, before surgery.
• Fasting: No food or milky drink for 6 hours before the procedure is usually required.
• Consent discussion: The surgeon outlines the procedure, risks and alternatives.
• Safety: Multiple final checks on the day of surgery.

Being well-informed reduces anxiety and provides clarity about the day of surgery.

On the day itself, patients are admitted to the hospital and prepared for the operation.

A typical pathway includes:

• Admission check-in: Nurses review paperwork and conduct final health checks.
• Anaesthetic administration: General anaesthesia is given so the patient is deeply asleep throughout.
• Surgery: The surgeon makes small incisions, inserts the laparoscope and instruments, and removes the gallbladder. A dye test of the bile ducts (intra-operative cholangiogram) is routinely performed to ensure remaining bile ducts are not injured.
• Completion: The incisions are closed with absorbable stitches.

The operation usually takes 40-60 minutes, depending on individual patient circumstances.

After surgery, patients spend time in the recovery area until they are fully awake.

Typical early recovery includes:

• Minor discomfort at incision sites: Pain relief is provided as needed. Shoulder ache, due to the gas inflating the abdomen during surgery, is normal for the first 12-18 hours. Heat packs and simple analgesia usually manage this adequately.
• Minor bloating, nausea, burping or diarrhoea with eating. Usually mild/moderate and temporary, for 1-2 weeks only.
• Eating & drinking: Most patients eat a normal diet immediately after surgery.
• Walking: Early gentle movement is encouraged to reduce the risk of blood clots and improve healing. Heavy lifting (more than 10kg) should be avoided for 4 – 6 weeks.

The hospital team monitors vital signs and provides discharge instructions before going home. Patients who are unsafe to go home will be kept in overnight.

It’s normal to experience a range of temporary symptoms during recovery. Recognising which are expected can provide reassurance.

These may include:

• Mild abdominal discomfort.
• Tiredness or fatigue in the first week.
• Loose stools or bloating after eating fatty meals.
• Shoulder or back ache related to trapped surgical gas, usually only for 12 hours.

These symptoms generally resolve within the first 1-2 weeks. However, patients should be aware of concerning signs such as fever, worsening abdominal pain, or yellowing of the skin and eyes, and seek medical advice if these occur.

Recovery varies from person to person, but many are back to light activities within days. Some find they need a little longer, especially if they have a physically demanding lifestyle.

Typical milestones:

• First week: Rest, short walks, and light meals, if required. Avoid heavy lifting.
• Week two: Many can resume desk-based work and gentle activities.
• Weeks three to four: Gradual return to exercise, driving and more routine tasks.
• Beyond one month: Most patients are fully back to normal routines. 

Dr Dodd will provide tailored advice to guide safe activity levels at follow-up appointments.

Like all operations, laparoscopic cholecystectomy carries potential risks. While complications are uncommon, it is important to be aware of them.

Possible risks include:

• Bleeding or infection.
• Injury to nearby organs such as the bile ducts or intestines.
• Blood clots in the legs or lungs.
• Anaesthetic-related side effects such as nausea.

Discussion with the surgical team helps patients understand how these risks apply to their situation.

Most people live normally without a gallbladder, given the fact it hasn’t been functioning normally for some time. Some patients may notice subtle digestive changes. These often improve as the liver increases its secretion of bile with meals.

Possible temporary changes include:

• More frequent stools after fatty meals.
• A period of bloating or indigestion.
• Needing to adjust diet to find what feels most comfortable.

Keeping meals balanced and limiting very rich or greasy foods can help during the early months after surgery. It is rare for such side effects to be a major problem long term. Patients with IBS, especially with diarrhoea, are more at risk of long term side effects.

If you have been advised to consider laparoscopic cholecystectomy in Brisbane, discussing the procedure with a dedicated Upper GI and Bariatric can provide clarity and peace of mind. At Dr Ben Dodd - Brisbane Upper GI Surgery, we offer laparoscopic cholecystectomy as part of our surgical services. Dr Dodd performs laparoscopic cholecystectomy every week and appreciates the nuances of who should and should not proceed with surgery. Our team welcomes you to get in touch via our contact page or give us a call to arrange a consultation. We are here to guide you through each stage, from preparation to recovery. Dr Dodd will happily answer all questions and always explains the option of avoiding surgery.