Open Gallbladder Surgery (Cholecystectomy)

Post-Operative Instructions

You will most likely be able to go home accompanied by a responsible adult. If you had general anesthesia, you may feel drowsy or nauseated for a temporary period of time that may last 12 to 24 hours.

Incision Care

If you notice any major swelling or severe discomfort in the first few hours at home, you need to call our office. (Some pain, as well as bruising, is expected and anticipated. This should resolve in a few days.)

As soon as you get home use an ice pack or put 10-12 ice cubes into a baggie and place this over the bandage. Keep ice on the bandage for the first twelve hours or so. This should not keep you from getting up and going to the bathroom or moving around in other ways.

Your abdominal wound may be covered by a gauze dressing. You may shower and remove your gauze dressing on the second morning (48 hours) after your surgery date. (Avoid baths or hot tubs for at least the first week.) You will likely have small pieces of tape (steri-strips) over your incision. These will naturally fall off over time, do not manually remove them. You may also have staples, which should be covered with gauze for showering. They may be irritating to the skin and cause redness. If this persists or enlarges, bring it to the attention of your surgeon.

Following abdominal surgery, it is not unusual for the abdominal wound to drain some clear fluid. This is very common for patients who are overweight. Do not be alarmed. It is safe to take a shower. Apply dry gauze to the abdominal wound. If you notice skin separation at this site, cover the area with dry gauze and notify your surgeon. It is crucial to notify your surgeon or go to the emergency room if you notice any unusual intra-abdominal organs protruding through your incision. This is a surgical emergency.

It is necessary for you to continue to wear your abdominal binder as advised. Usual recommended time is anywhere from 4-6 weeks. You may take off the binder at night when resting in bed.

Diet

You may resume a regular diet when you return home, however it is recommended that you eat light, easily digestible food for the first day or so after surgery. It is highly recommended you avoid foods that give you excessive gas, such as radishes, raw vegetables and baked beans. Avoid hot, spicy foods in the initial few days to allow your gastrointestinal tract to return to normal. You should not have carbonated beverages for 48 hours after surgery. After a few days, when tolerated, eat plenty of fruits, vegetables, and/or bran flakes and drink plenty of fluids (including some prune juice) to avoid constipation, particularly if you are taking narcotics for post-operative pain control. (You may have a gentle laxative, such as 1-3 tablespoons of Milk of Magnesia if you have not had a bowel movement for three days.)

Medication

Please be sure to take all medications that you usually take on a regular basis. However, it would be a good idea to avoid aspirin, Motrin or Advil for five days after your operation.

Pain medication will be prescribed for you; you may take it as needed. You should avoid driving, operating heavy equipment, or potentially hazardous garden equipment while taking narcotics. Side effects of narcotics may include nausea, vomiting, lightheadedness, rash, irritability, or fatigue. Once pain begins to subside, you may try switching to some plain Tylenol after the first day or two since you may no longer need the narcotic. This will help avoid constipation as well.

You should also take a stool softener if prescribed by your surgeon. You may have a gentle laxative, such as 1-3 tablespoons of Milk of Magnesia if you have not had a bowel movement for three days.

Activity

You are to avoid heavy lifting in the first two weeks—no greater than 10 pounds. After two weeks that can be increased to no more than 20 pounds. Some bruising or black and blue areas around the surgical site are not unusual and will resolve over the next few days.

Activities such as deep breathing, walking and going up the stairs will encourage the resolution of some of the stiffness and discomfort and is highly recommended. Many people have problems sleeping after an operation. This is usually the result of too many naps during the daytime. Adequate activity should resolve this problem.

Resumption of driving is dependent on the type of procedure you have had and your level of pain and mobility—generally a few days to up to two weeks after surgery. After major abdominal surgery, it is recommended you wait until your first post-operative visit to the surgeon before initiating any driving. As always, wait to drive until common sense says it is safe to do so. You must no longer be taking narcotics, and must be able to respond physically and cognitively to any situation on the road you may encounter.

Call the Office at (815) 717-8730

• When you return home from surgery to schedule a follow-up appointment to take place 7-10 days after surgery.
• If you have bleeding from the surgical site that requires more than two dressing changes.
• You are still unable to have a bowel movement after trying Milk of Magnesia on the third day following surgery.
• You develop a fever of 101° F or 38.5° C or higher following the day of surgery. However, low-grade fevers are not unusual after abdominal surgery and should be managed with coughing, deep breathing and walking. You may use over-the-counter Tylenol (650 mg every 6 hours as needed).
• If you have any other problems or concerns.

Go to the Emergency Room:

• If you have been unable to urinate six to eight hours after being discharged from your surgery and have a feeling of fullness, let the tap water run to instigate urination. If you are still unable to urinate, go to the emergency room.
• If you notice any unusual intra-abdominal organs protruding through your incision.
• If you have serious problems and are unable to reach your surgeon or office staff.