An open cholecystectomy is a surgical procedure done to remove the gallbladder. The liver produces bile, which serves to break down fats during digestion. Bile is stored in the gallbladder, a pouch on the right side of the abdomen under the liver. Bile, which is secreted from the gallbladder after a meal, travels to the small intestine, where it aids in digestion. When there is a problem with the gallbladder, it may be removed using an open cholecystectomy procedure.
Bile is made up of bile salts, water, cholesterol, and bilirubin. If a person develops an imbalance in these components, the bile may harden to form gallstones. These gallstones can block the bile ducts, which allow bile to move from the gallbladder to the small intestine, and cause bile to back up in the gallbladder. This can lead to an infection or inflammation of the gallbladder, which can be life threatening if left untreated. A physician may elect to perform an open cholecystectomy to remove the gallbladder.
An open cholecystectomy may also need to be done if the patient has other disorders of the gallbladder that do not involve gallstones. Biliary dyskinesia is a gallbladder disease in which the muscles of the gallbladder will not function to secrete bile. Cancer can also develop in the gallbladder and would require that it be removed.
Many patients with gallbladder disease qualify for a laparoscopic cholecystectomy. During this procedure, the surgeon makes three to four small incisions in the abdomen and inserts a camera and surgical instruments. The gallbladder is located and removed through one of the incisions. This procedure requires a shorter hospital stay and a shorter recovery, but it may not be appropriate if the gallbladder disease is severe.
For severe gallbladder disease, the physician would probably want to do an open cholecystectomy. The open procedure is done while the patient is under general anesthesia, and it allows the surgeon to get a full view of the gallbladder and bile ducts. An incision is made on the right side of the abdomen under the ribs. The bile ducts are severed and the gallbladder is removed. If any gallstones are present, the surgeon can check for those during the open procedure.
The open cholecystectomy requires the patient to spend five to seven days in the hospital. While in the hospital and after returning home, the patient will be encouraged to do breathing exercises to keep the lungs inflated. The patient will usually be able to resume normal activities in four to six weeks.