About the Gall Bladder Operation or Cholecystectomy - Part Two
After the operation
Will there be any stitches? Some surgeons place all the stitches under the skin so that they do not need to be removed. Others use clips and stitches in the skin which do need to be removed after about a week. Some of the small incisions may in fact be closed with adhesive strips that will peel off in the shower. You should be told clearly about this before you leave hospital.
What about recovery?
Returning home When the patient returns home depends on their level of fitness, whether there is an adult at home to help them and how much discomfort they have. After laparoscopic cholecystectomy most patients will be able to be discharged one or two days after the operation. Open operations mean that most patients stay a day or so longer before discharge, but overall they can return home when they feel ready.
Pain and painkillers People vary in the pain they feel after a cholecystectomy. Some get very little discomfort but it is common to experience some symptoms during the first 3 or 4 days. Although some of the discomfort may be around the sites where the telescope and instruments were passed, some people get pain in their shoulders. This is due to irritation of the diaphragm at the operation and will settle as the carbon dioxide gas is absorbed. Use of the painkillers for the first few days is advised, to allow patients to become active and to sleep with comfort. Patients should be pain-free within the first 5-10 days after the operation. Recovery after open operation will be a bit slower.
Bathing and showering Patients can wash the wound gently with soap and water in the bath or shower after about 2 days. Some surgeons use a transparent dressing which can be left on for several days even when washing or bathing, advice will be given about this. It is probable wise to avoid swimming until the wound is sound and dry " about 10 days after the operation.
Getting about Getting up and walking about can be done as soon as the patient wishes and although there is no limit on this it is likely stiffness and some tiredness might limit the distances possible for about a week.
Driving a car Patients need to feel able and confident that they can control a car in an emergency situation before they drive, taking a few days to reach this point.
Sport, heavy lifting and work Return to work can be accomplished as soon as a patient feels comfortable enough to cope with the job demands. Home or part-time workers can usually resume work very soon after the event. Driving to work or spending a lot of the day on the feet delays work return for about two weeks. Full time work is usually achievable for most people after laparoscopic operation by ten days from the procedure but if they have had an open operation this will be a few days more.
Physical activities and sports can be resumed as soon as he patient's discomfort allows but a graded return to these pursuits would be advised as fitness is regained. A month or more may be needed before resumption of contact or violent sports.
What other effects will there be? Bruising and some swelling are common in the areas where the telescopes were inserted or around the wound if an open cholecystectomy has been performed. The swelling and hardness are caused by the fluid and blood under the wound, pulling together by the stitches and later by the formation of scar tissue.
Problems which can happen after a cholecystectomy
Haematoma The possibility of bleeding occurring has been mentioned already but at times there can be extensive bleeding if a small artery or vein under the wound bleeds for a while after the operation. This looks like a firm lump and usually settles down without treatment.
Wound infection A wound infection is possible but not common. Wound redness developing may necessitate the use of antibiotics. If the wound should drain pus then it may need reoperation to let out the infection.