Laparoscopic Cholecystectomy

The Procedure

The operation involves removing the gall bladder, a small pear-shaped sac sitting just under the liver. The gall bladder is a reservoir for bile, before it flows down the bile duct and into the small intestine. Bile aids the digestion of food in the intestine. After the gall bladder is removed, the bile flows directly into the small intestine; this does not cause any difficulty with digestion.

The operation involves ‘key hole’ surgery to remove the gall bladder. A surgeon inserts a laparoscope (a thin telescope with a camera at the end) into the right side of your upper abdomen via small incisions (cuts about 1-1.5 cm long). Patients usually have 4-5 incisions in the abdominal and umbilical (tummy button) areas, and these will be closed using stitches or clips. The stitches are usually dissolvable and do not need removing.

Before your operation

You will be having a general anaesthetic and will have a Pre-assessment appointment to assess you suitability for day surgery, before you are given a date for your operation.
At this appointment the nurse will take details of your:

• medical history
• current medication
• home care arrangements after you have been discharged from hospital.

Please use this opportunity to ask any questions about your surgery and after-care. The nurse will give you instructions about preparing for your operation, which will include advice about:

• having a bath or shower before you come to the hospital
• eating and drinking
• taking your normal medication, if appropriate
• returning to work after surgery

The Surgical Admissions Team will contact you to agree on a date for your surgery.

On the day of surgery

Please bring in all your medications you are currently taking including inhalers.

You should have a bath or shower before you come to hospital.

If you wear contact lenses, you will need to remove them prior to your operation. Please bring your spectacles or an extra pair of contact lenses with you.

On admission to the admission unit you will be greeted by a nurse who will check that your details are correct and help you to prepare for your surgery. The surgeon and the anaesthetist will talk to you and you will be invited to ask any questions you may have.

The surgeon will also ask you to sign a consent form for the operation and if appropriate, your operation site will normally be marked.

A member of staff will escort you, as you walk to the operating theatre.

Following your operation

You will be transferred to the ward area where nurses will continue to monitor your condition. If you feel any discomfort, please inform the nurse looking after you, so that pain relief can be given.

You will be allowed to rest on the unit until the nurse looking after you assesses you are ready for discharge.

As long as you do not feel sick (after general anaesthetic) you will be encouraged to have something to eat or drink prior to going home. The majority of patients will go home on the same day as their surgery but some may be advised to stay overnight.

Care at home

You will need a relative/ friend or carer who can escort you home and stay with you for the first 24 hours after your procedure.

We advise you that you have a supply at home of simple pain killers such as paracetamol and ibuprofen. Please take only as directed on the packaging. If you require any further medication the hospital will supply this.

You should seek medical attention immediately if you develop:

• bruising or swelling around the operation site
• worsening abdominal pain
• a fever or shivering

The stitches in your wound should be dissolvable. Some patients have Steristrips_^TM (small strips of adhesive tape) rather than stitches in their wounds.

You may shower on the day following your surgery. The waterproof dressings over your wounds should remain in place for 48 hours, then you may remove them. A high fibre diet is recommended to help reduce straining, when having a bowel movement. You can shower the day after your surgery but please do not have a bath or submerge in water for 2 weeks.

You should remain off work for approximately 2 weeks, or as directed by the surgeon. You may drive when you feel you can safely perform an emergency stop. This will not be for the first 48 hours following your surgery. Please check that your insurance policy does not prohibit you from driving for a longer period, following general anaesthetic or surgery.

What are the possible complications:

Please contact your GP, if you develop:

• abdominal swelling
• a fever or shivering
• fresh bleeding or bruising
• redness or swelling at the operation site
• pus or drainage from the operation site
• prolonged or severe pain

Will I need to come back to the hospital?

We will tell you before you go home if you need to come back to the outpatient clinic. We will also send you an appointment date and time in the post.

If you have any problems or cause for concern please contact

• The relevant Day Unit: