Saturday, April 4, 2009

After a GallBladder Surgery or Cholecystectomy




By Jonathan Blood Smyth

After Gallbladder Surgery

Stitches and clips If the surgeon has used sub-cuticular clips then they do not need removal but if skin clips or stitches are employed then removal will be required at about a week after insertion. The small incisions are often controlled by using adhesive strips which gradually come off in whilst showering. Patients should be given clear advice on managing their wounds and stitches.

What about recovery?

Going home This depends on how fit the patient is, who is at home with them and how comfortable they are after the operation. Most patients after laparoscopic cholecystectomy should be able to go home within 1 or 2 days of the operation. After an open operation it is common to need to stay a day or two longer. In general a person can go home as soon as they feel able to do so.

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.

Having a bath and shower Soap and water can be applied to the wound area either by showering or having a bath after around two days. A transparent wound dressing is used by some surgeons, left in place for a while and washing or bathing can continue with it on. Patients will usually be advised about this. Swimming is best avoided for about ten days or so until wound healing is well advanced.

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.

Car driving Typically driving a car can be resumed when patients feel confident and able to control the vehicle in an emergency, after a few days from the procedure.

Work, sport and heavy lifting Patients can return to work as soon as they feel comfortable enough to manage their job. People who work from home or who can go back part-time often do so very soon after the operation. If they need to drive themselves or spend all day on their feet then they are unlikely to get back for about 2 weeks. Most people after laparoscopic surgery should be able to return to full time work within 10 days. It will take a few days longer after an open operation.

The level of discomfort suffered is the guide to when sports and other active pursuits can be restarted. To regain fitness successfully a gradual resumption is advised. To return to violent and contact sports typically requires at least a month.

Side effects which might occur The sites where the telescopes have been inserted or the wound site in an open operation usually suffer some swelling, bruising and hardness. Fluid and blood collection under the wound causes the hardness and swelling initially, added to by the drawing together of the stitches and then by scar tissue formation.

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.

Infection Infection of the wound is a risk but is uncommon. If a wound starts to become red then antibiotics may be needed. If pus starts to come out then the wound may need to be opened up to release the infection.

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