Specialty Procedures: 
Cholecystectomy: What to expect after surgery

Both laparoscopic and open cholecystectomy are major operations. Important post -operation issues are discussed below.

Pain 
Although the pain following laparoscopic cholecystectomy is significantly less than that associated with the open operation, some discomfort, in the abdomen and the shoulder, will occur. This pain gradually resolves over the first 24 to 36 hours but may persist for as long as 4 to 5 days. Once you are home, you should take pain medications as needed. You will be given a prescription for an oral narcotic that is quite useful in the evening before you go to bed or during the day should you have particularly severe pain. This medication may make you slightly drowsy or lightheaded and will certainly cause constipation if it is taken in large doses. Most people find that they do not need the narcotic pill after the first 2 or 3 days.

Incisions 
Your incisions will be closed with stitches that will dissolve on their own. You do not need to have the stitches removed. The incisions are covered with a clear adhesive tape known as Steri-strips. These should be left in place for 7 to 10 days. If they fall off in the shower, do not be concerned. If they are still there at the end of 2 weeks, you may remove them. Gauze dressings are not normally required but you may find that placing a gauze over the incision prevents irritation from clothing. You may shower, bathe or swim whenever you desire.

Diet 
You may eat anything that you desire. It is strongly recommended that you do not try to eat everything at once and stick to relatively light foods for the first 2 or 3 days. After that, as your appetite increases, you may add more to your diet.

Bowel Movements 
Some patients find that it takes 3 or 4 days to have a normal bowel movement. If you have not had a bowel movement by the evening of the second postoperative day, feel free to take some Milk of Magnesia. That and large amounts of liquids will assist you in having your first bowel movement. Some patients may find that they have a certain amount of diarrhea for the first 3 or 4 weeks after surgery. Do not be alarmed by this. Your bowels will soon return to normal. If the diarrhea is bothersome, please take Kaopectate or Imodium both of which can be obtained without a prescription in the drug store.

Activity 
There should be no restrictions to your activity. You may do anything that is comfortable. You may lift anything, you may exercise as you desire. You may have intercourse, and you may swim. You may drive if you have stopped the narcotic pain medications.

Conditions to Look For 
Although cholecystectomy is a remarkably safe procedure, problems can arise. Should any of the following occur, please contact your physician as soon as possible:

1. Fever greater than 101 degrees.

2. Persistent vomiting after the third postoperative day.

3. Failure to have a bowel movement after four days.

4. Persistent abdominal distention and tenderness.

5. Increasing tenderness at the site of the skin incisions. Please note that the incisions will be red and uncomfortable for approximately 10 days. If pus develops or if areas of enlarging redness occur, please call your physician.

Final Visit 
You should see your surgeon for a final office visit approximately three to four weeks after the surgery. Please do not hesitate to contact your doctor at anytime if things do not appear to be going smoothly.