By: Eveline Shue, MD, FAAP
Cholecystectomy is a type of surgery to remove the gallbladder, a small, hollow organ that stores digestive fluids. It is one of the most common surgeries among U.S. adults. A growing number of children also have the procedure.
Conditions it treats
How is gallbladder surgery performed in children?
Laparoscopic surgery. Gallbladder surgery is usually done using a video camera and small incisions. There are usually between 2 and 4 incisions, each less than 1 cm in length. The stones and the gallbladder are removed in this surgery.
Cholangiogram. This may be performed as part of the operation if the surgeon feels it is necessary. It is done by putting dye into the bile ducts and taking x-rays of those ducts to see if there are stones stuck in them.
Open surgery. Sometimes there is too much infection around the gallbladder and it is not safe to do the surgery laparoscopically. If this happens, your surgeon may need to do the surgery with one bigger incision.
What happens before surgery?
Doctors will want to make sure your child is as healthy as possible before surgery. If there is infection in the gallbladder, your child may be given antibiotics before surgery. For children with sickle cell anemia, blood transfusions may be needed before surgery to prevent a sickle cell crisis.
Patients are usually asked to take a shower or bath the night before surgery. Your child will also need to stop eating or drinking for at least a few hours before surgery.
When can my child go home after surgery?
If your child has laparoscopic surgery, they likely can go home the same day as the surgery, or the next. If a bigger incision and open surgery is needed, your child may need to stay in the hospital up to 5-7 days.
How do I care for my child at home after gallbladder surgery?
Taking care of the wound. Wounds should be kept clean and dry for 2 days. Most of the time, the stitches used in kids dissolve on their own and do not require removal. Your surgeon will give advice about how to care for the wounds.
Limit activity while healing. Your child should avoid intense activity and avoid heavy lifting for 2 weeks after a laparoscopic surgery, and 4-6 weeks after open surgery.
Diet. Most children can eat a normal diet after surgery. Sometimes, eating lots fatty foods may cause nausea, bloating, cramping and watery stools. These problems will likely go away in a few months as the body adjusts to not having a gallbladder.
Medicines your child may need to take. For a few days after surgery, Tylenol or ibuprofen may be used for pain. Sometimes, your doctor will give you a stronger pain medication to help with pain for the first few days after surgery. It is common for children to have constipation after surgery (trouble passing a stool). If this happens, your child may need to take medicine to make their stool soft.
Problems to watch for during recovery. Call your doctor if your child's pain gets worse, has a fever, vomiting, yellowing of the eyes or skin or if the wounds are red or draining fluid.
What are possible complications with gallbladder surgery?
Injury to the ducts draining the liver
Injury to the blood vessels of the liver
Leakage of bile from the ducts
These complications are rare, happening in less than 1% of surgeries. Your surgeon can discuss these with you.
When will my child need to see the doctor again?
Children who have had gallbladder surgery will need to see the surgeon 2-3 weeks after surgery to make sure they are healing well. They should also continue to see their pediatrician regularly.
What is the long-term outlook after surgery?
The long-term result is excellent after surgery. Rarely, some people may feel bloated or have loose stools after eating fatty foods after their gallbladders are removed. This is usually temporary. See your pediatric surgeon if your child experiences these symptoms.
About Dr. Shue
Eveline Shue, MD, FAAP, a member of the American Academy of Pediatrics Section on Surgery, is a pediatric general surgeon at Children's Hospital of Los Angeles and Long Beach Memorial Children's Hospital.