Why the operation is done in the first place
Gallbladder removal is the usual treatment for gallstones that cause symptoms, such as bouts of pain in the upper right or middle of the abdomen after eating, inflammation of the gallbladder, or stones that move into the bile duct. The UK NICE guideline recommends offering laparoscopic removal to people with symptomatic gallstones. [1, 10]
Gallstones found by chance on an ultrasound that cause no symptoms usually do not need an operation, and that is an important distinction before anyone starts planning an operation day. [1, 2, 10]
People can live a normal life without a gallbladder, because the liver keeps making bile and it flows straight into the bowel instead of being stored in the gallbladder first. Some people notice a change in digestion or diarrhoea for a while after the operation, and this usually improves. [4, 6]
This article focuses on the operation day itself: preparing for it, what happens in hospital and going home. Choosing the type of operation is covered in a separate article. [3, 4]
The pre-operative assessment
Days or weeks before the operation there is usually a pre-operative assessment. The team asks about your general health, long-term conditions such as high blood pressure, diabetes, heart or lung disease, previous operations and anaesthetics, and any medicine allergies. [5, 9]
Blood tests, a heart tracing or scans may be requested depending on your age and health. If a stone in the bile duct is suspected, extra tests may be arranged before or alongside the operation, because that changes the plan. [5, 10]
This is also the right time to ask your questions: will the operation be keyhole? Roughly how long will it take? Will I go home the same day or stay overnight? Who will follow me up afterwards? [4, 9]
If you smoke, the assessment is a good moment to stop, because stopping smoking before any operation reduces lung and wound problems. [5]
Medicines and fasting: instructions come from the team, not the internet
A key part of the pre-operative assessment is making sure the team knows every medicine you take, including blood thinners, diabetes medicines, herbal remedies and supplements. Some of these may need to be stopped or adjusted before the operation, while others must continue. [5, 9]
Stopping or adjusting is done only on written instructions from the team, not as a personal decision. Stopping a blood thinner or heart medicine without instructions can be dangerous, just as continuing it without the team knowing can increase bleeding. [5]
Fasting before a general anaesthetic matters so that the stomach is empty during anaesthesia. The number of hours without food and drink varies, and the hospital gives specific times; follow them exactly, neither much longer nor shorter. [5, 8]
If you have diabetes, ask specifically about your tablet or insulin dose on the day, and what to do if your sugar drops while you are fasting. [5, 9]
Plan for going home before you go in
Most people who have laparoscopic gallbladder removal go home the same day or the next day, but this depends on the case and the hospital. So arrange in advance for someone to drive you home, because you cannot drive after a general anaesthetic. [4, 5]
It is also best to have a responsible adult with you at home for the first 24 hours after the anaesthetic. This is often forgotten, and not having it can delay a same-day discharge. [5, 8]
Prepare your home beforehand: loose clothes that do not press on the wounds, light and simple food, the painkillers the team prescribes or approves, and a place to sleep and rest without many stairs if possible. [5, 6]
Arrange time off work according to the type of work you do. Desk work is different from work involving lifting or physical effort, and the team will tell you when to return based on your recovery. [4, 6]
The operation day step by step
When you arrive at the hospital, your details, the planned operation and any allergies are confirmed, and you sign the consent form if you have not already. You will notice these questions being repeated more than once by more than one person; that is a deliberate part of the safety system, not an oversight. [5, 9]
The anaesthetist sees you before the operation and asks about fasting, medicines and previous anaesthetics. The operation itself is done under general anaesthetic, so you will be asleep and feel nothing. [4, 8]
In keyhole surgery the surgeon makes a few small cuts in the abdomen, inflates it with carbon dioxide gas to see clearly, and removes the gallbladder through one of the cuts. A laparoscopic operation usually takes around an hour to an hour and a half. [3, 4, 8]
In a small proportion of cases the surgeon may convert to open surgery during the operation if keyhole surgery is not safe, for example because of severe inflammation or difficulty seeing the anatomy. This is a safety decision, not a failure, and it is worth asking about beforehand. [3, 7] To learn why teams pause repeatedly, read about repeated safety checks before surgery.
After you wake up
After the operation you wake up in the recovery room, where the team monitors your pulse, blood pressure, breathing and pain. Feeling dizzy, drowsy or a little sick from the anaesthetic is normal. [4, 8]
Mild pain at the wound sites is expected. Many people also feel pain in the shoulder after keyhole surgery, caused by the gas used to inflate the abdomen, and it usually eases within a day or two. [6, 8]
The team encourages you to get up and walk early, and to start drinking and eating something light when you are ready. Before discharge they usually check that you can drink, pass urine and that your pain is controlled with tablets. [4, 6]
Before you leave, make sure you have written instructions on wound care, painkillers, showering, when to remove dressings, when your follow-up is, and a number to call if there is a problem. [6, 9]
The first days at home
Most people return to normal activities in about two weeks after keyhole surgery, while open surgery needs longer. Light walking every day helps, and heavy lifting is postponed until the team says it is fine. [4, 6]
Eating can return to normal gradually. Some people find fatty food bothers them at first or causes diarrhoea, and adjustments are guided by what you notice, without a special diet unless the team asks for one. [4, 6]
Driving can resume when you can move easily and do an emergency stop without pain, and when you are no longer taking painkillers that make you drowsy. [6]
Complications are uncommon but can happen: wound infection, bleeding, bile leakage, injury to the bile duct or bowel, or a blood clot in the leg. That is why knowing the warning signs after the operation matters. [7, 8]
What to take to hospital
Pack a small bag the night before so the morning is not rushed. Bring a written list of every medicine you take and the doses, or the medicines themselves in their original boxes, because this helps the team review them quickly and without confusion. [5, 9]
Bring loose, comfortable clothes for the journey home and shoes you can put on without bending much. If you are staying overnight, bring a toothbrush, basic toiletries and a phone charger. [5]
Leave jewellery and valuables at home, and follow any other hospital instructions about make-up, nail varnish or contact lenses, because each hospital has its own instructions before anaesthesia. [5, 9]
Bring any test or scan results done outside the hospital, and the phone number of the person taking you home, so the team can call them when you are ready to leave. [5, 9]
Questions to ask the surgeon before the operation
The visit before the operation is the best time to understand your plan exactly, and writing your questions down stops nerves from making you forget something important. Useful questions include: why is the operation right for my case, and what might happen if I delay it or do not have it? [3, 10]
Also ask: will it be keyhole? What is the chance of conversion to open surgery in my case? What are the most common complications, and how are they handled if they happen? [3, 7]
About the day itself: exactly when do I stop eating and drinking? Which medicines do I take in the morning? Which do I stop, and when do I restart them? Will I go home the same day or stay overnight? [5, 9]
About afterwards: when can I go back to work? When can I drive? How do I care for the wounds and shower? And if there is a problem at night, who do I call? These answers reduce worry and make going home easier. [4, 6]
When to call the team or go to the emergency department
Call the team or go to the emergency department if you have severe or worsening abdominal pain, fever, yellowing of the skin or the whites of the eyes, persistent vomiting, redness, heat or discharge from a wound, swelling and pain in the calf, or shortness of breath. [6, 7]
These symptoms can be signs of a bile leak, infection or a clot, and all need prompt assessment rather than waiting. The full details are in our article on recovery warning signs after gallbladder surgery. [7]
If you are still comparing approaches, read about laparoscopic or open gallbladder surgery. If you want to understand the symptoms that make the operation necessary in the first place, read about gallstone symptoms and when surgery is needed. [1, 3]
If you have gallstones that cause symptoms and want to understand whether the operation suits you and what will happen on the day, book an appointment with the surgeon and bring your questions written down. [9, 10]
