This article answers five of the most commonly asked questions about what happens immediately after gallbladder removal before discharge from hospital and during the first day of gallbladder surgery recovery at home.
What Pain Can Be Expected?
The incision sites of the cholecystectomy through which instruments entered and exited and the gallbladder was removed will be painful. This pain however will be managed initially by intravenous painkillers through a drip and then with oral pain medication. The incisions will also be swollen with some bruising. To ensure hygiene and prevent infection the incisions will be covered.
Gallbladder removal surgery usually results in pain which the majority of patients rate as mild to moderate once the general anaesthetic wears off and can be managed with over the counter medications. Either paracetamol, also known as acetaminophen or APAP, often branded as ‘Tylenol’ or ibuprofen, often branded as ‘Advil’ or ‘Motrin’ will usually be sufficient. If pain is intense narcotic painkillers may be prescribed. It is important to be aware that side effects of these drugs can include nausea, dizziness and constipation. It is reassuring for most patients to know that most gallbladder surgery pain will be able to be managed with over the counter medication.
During gallbladder surgery the abdomen is inflated with carbon dioxide gas. One side effect of this is sore shoulders. Another is feeling bloated which can be expected to pass within 48 hours. Gentle exercise, that is short slow walks, will also help the gas to be absorbed into and pass through the digestive system.
Why Might The Patient Experience Nausea?
Immediately following gallbladder removal by laparoscopic keyhole surgery the patient may feel nauseous as a result of the general anesthetic and painkillers which were administered during surgery. People react differently to general anesthetic with some having few side effects, for others however they will be quite sick including vomiting in which case anti-nausea drugs will be administered.
Is a Wound Drain Necessary?
It is very unlikely that gallbladder removal through the minimally invasive procedure laparoscopic cholecystectomy, often called key-hole surgery, will require a wound drain. A drain is a thin rubber tube which is inserted through the wound into the abdomen to drain bile, blood and fluids. The site of an open cholecystectomy may require ‘drain’ which will be removed in the days following surgery.
When Can the Patient Leave Hospital?
For most patients recovery from gallbladder surgery is incident free and they are able to leave hospital the same day. Because gallbladder removal through keyhole surgery is considered a minimally invasive procedure it is frequently performed in outpatient surgery, which may also be called ambulatory surgery, same-day surgery or day surgery. Because of this most patients will go home on the same day as their gallbladder removal surgery.
Before being discharged from the surgery the patient will be required to have eaten soft food and had a drink and to have kept these down, that is not vomited. They will also need to be able to walk.
Patients will need someone to take them home from the surgery. Ideally someone should stay with and monitor the patient for the first 24 hours of their gallbladder surgery recovery.
What Wound Care Is Required After Discharge From Hospital?
During gallbladder surgery the incisions are most likely to be sutured, or stitched, with dissolvable stitches. These do not have to be removed but will breakdown in a week or two as the wound heals. Steri-Strip skin closures are also placed over the wounds. They are strong, slim, waterproof adhesive strips that will hold the incision together. Being waterproof the patient can shower without worrying they will come unstuck. Steri Strips come off by themselves after 5-7 days; they will begin to peel away from the skin and then fall off. A gauze and water-proof dressing will be placed over the wound to keep the area clean and prevent infection.
During the first 24 hours of gallbladder removal recovery there may be some discharge from the incisions. If the discharge is watery, thin and a very light pinkish color this is normal and should not be of concern to the patient. If the discharge is thicker bright red blood the patient should contact the outpatient surgery.
It is also normal after gallbladder surgery for the incisions to be swollen and bruised. However if the skin surrounding the incision is red or feels warm when touched or if the discharge from the wound is thick green or yellow this many indicate an infection. In this case the outpatient surgery or doctor should be contacted.
To help prevent infection it is recommended that using swimming pools, spas and soaking hot tubs be avoided for 4 to 6 weeks after gallbladder removal surgery.
Nursing staff will provide the patient with specific information about how to care for the wound prior to being discharged from the outpatient surgery. Patients are frequently provided with a pamphlet explaining how to care for their wound and when to contact the surgery or doctor while recovering from gallbladder surgery.