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Having your gallbladder cancer operation

Men and women discussing gallbladder cancer

This page is about having surgery for gallbladder cancer.

 

A quick guide to what's on this page

Having your gallbladder cancer operation

When you go in to hospital for your gallbladder operation, your surgeon, anaesthetist, nurse, physiotherapist and dietician will all come and talk to you. The surgeon will explain the operation. Ask as many questions as you need to. It may help to make a list beforehand.

Immediately after your operation

To start with, you are likely to have tubes in place to give you fluids, drain the wound, and drain your urine. Your nurses will encourage you to get up and about as soon as possible. This helps prevent blood clots and chest infections. A physiotherapist will teach you breathing and leg exercises to help with this too.

You are likely to have some pain for the first few days. Tell your doctor and nurses, who will work with you to find the right painkiller for you. After surgery to any part of the digestive system, the bowel usually stops working for a while. Until it starts up again, you will not be able to eat or drink anything. How long it will take for you to be able to eat and drink depends on how much surgery you have had.

Making progress

After a few days you will gradually begin to feel better, and start to be up and about. It is natural to feel tearful after this type of surgery. You will need lots of support from doctors and nurses, family and friends to make a full recovery.

 

CR PDF Icon You can view and print the quick guides for all the pages in the treating gallbladder cancer section.

 

Before your gallbladder operation

When you go into hospital for your operation, your surgeon, anaesthetist, physiotherapist, nurse and dietician, will all come to talk to you about what will happen. Your surgeon will explain what is going to be done and what to expect when you come round from the anaesthetic. Ask as many questions as you need to. It may help to make a list of questions before you go into hospital for your operation. There are some suggestions for questions at the end of this section. The more you know about what is going to happen, the less frightening it will seem. Don’t worry if you think of more questions later. Just speak to your nurses. If they can't answer your questions, they can contact the doctor to come and talk to you again.

If you smoke, it is best to try and stop before such major surgery. If you stop for at least 3 weeks beforehand, you will lower your risk of getting a chest infection after your operation and increase your chances of a good recovery.

You will have

  • Blood tests to check your general health, liver and kidney function
  • A chest X-ray to check that your lungs are healthy
  • An ECG to check your heart is healthy

You may have had some of these tests while your cancer was being diagnosed. If so, you may not have to repeat them. You may also be asked to have

  • Breathing tests (called lung function tests)
  • An ECG while you are exercising

These tests are just to make sure that you are fit enough to make a good recovery from your surgery.

If you have been finding eating and drinking difficult, you may have a drip (intravenous infusion) put into your arm before your surgery so that you can be given fluids. This helps to make sure you are not dehydrated before your operation.

A physiotherapist will teach breathing and leg exercises to you. You can help yourself to get better by doing these exercises after your operation. You should do them as often as you are told you need to. Breathing exercises help to stop you getting a chest infection. And leg exercises help to stop blood clots forming in your legs. Both these complications of surgery can happen if you are not able to move around as much as you would normally. Your nurses will encourage you to get up and about as soon as possible after your operation. But some of these operations are major surgery and you may have to stay in bed for the first day or so.

Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.

 



 

View a transcript of the video showing breathing and circulation exercises after surgery (opens in new window)

 

Immediately after your operation

If you have had a big operation you may wake up in intensive care or a high dependency recovery unit. This is nothing to worry about. These are places where you can have one to one nursing care. And your surgeon and anaesthetist can keep a close eye on you. As soon as they are sure you are recovering well, you can move back to the ward.

When you wake up, depending on the operation that you have had, you may have several different tubes in your body. This can be a bit frightening. But it helps to know what they are all for. You will have

  • Drips (intravenous infusions) to give you blood transfusions and fluids until you are eating and drinking again
  • A tube down your nose and into your stomach (nasogastric tube) to drain fluid from your stomach and stop you feeling sick
  • One or more tubes, called wound drains, coming out of your tummy (abdomen) near your wound
  • A tube into your bladder (catheter) so that your urine output can be measured

The wound drains stop blood and tissue fluid collecting around the operation site. This allows your wound to heal and helps to stop infection. The wound drains are connected to suction bottles, which are emptied every day. They can be taken out once the fluid has stopped draining.

You may also have a very thin tube into your neck or arm to measure your blood pressure in the veins that go into your heart. It is called a central venous pressure or CVP line. It will be connected to a screen.

When you first wake up, you will have a little clip on your finger to measure your pulse, blood oxygen levels and blood pressure. This is called a pulse oximeter. You may also have an oxygen mask on for a while. Your blood pressure will be measured quite often for the first few hours after you wake up from the anaesthetic. If you have had very major surgery, your blood pressure will be measured more often and for longer. At first it will be monitored through the tubes that go into your neck or arms. These go directly into a main blood vessel and give your doctors a more accurate measurement than a blood pressure cuff on your arm. You may hear these readings called central venous pressure or CVP. Your urine output will also be monitored because it can help show whether you have too much fluid in your body or are getting dehydrated.

You may have a couple of electronic pumps attached to your drips. These are for controlling any medicines you have through your drip. If you have had major surgery to your pancreas, you may have an extra pump containing insulin. It is important that your insulin levels are kept within normal range. Your nurse will test your blood insulin every hour or two at first. The pump will be set to give you just the amount of insulin you need.

Because you have had major surgery and an anaesthetic, you may feel a bit lost and confused when you wake up on the ward. This can be frightening and may make you feel as if you have no control over things. Staff will be very aware of this and visit you often to see if you need anything. You will have a call bell close by, so that you can call for help whenever you need it.

 

Painkillers

If you have had a big operation then you will almost certainly need painkillers for at least the first week. There are many different painkillers you can have. It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly, so let the staff know if you have pain.

Many hospitals now use painkillers through a drip into the spine after this type of surgery. You have probably heard this called an epidural - it is a common type of pain relief during childbirth. It works very well and means that it is much easier for you to move around after your operation. You will probably have the epidural for a couple of days at least, and then move onto painkillers as tablets.

If you have painkillers through any sort of drip, you will have an electric pump to control the dose. You may have a hand control for the pump, with a button to press to give yourself extra painkillers as you need them. This is called PCA or patient controlled analgesia. Do use it whenever you need to. You can’t overdose - the machine is set to prevent that. Do tell your nurse if you need to press the button very often. You may need a higher dose in the pump.

You can find more information about pain and pain control in our section on coping physically with cancer.

 

Eating and drinking

After surgery to any part of the digestive system, the bowel usually stops working for a while. Until it starts up again, you will not be able to eat or drink anything. The time it takes for you to be able to eat and drink again depends on how much surgery you have had. If you have only had your gallbladder removed, you will probably be able to eat and drink within 24 hours. But if your surgery involved your liver, pancreas, stomach or bowel then you will not be able to eat or drink for at least a few days.

If you were ill for some time before your surgery, you may be very run down and malnourished. You may need extra help with nutrition to start with, so your doctor may give you a white liquid called TPN through your drip. TPN stands for total parenteral nutrition. It contains all the protein, fat and carbohydrates that your body needs.

Once your bowel starts working again, you will be able to try sips of fluids. Gradually the amount you are allowed to drink will increase. And soon you will be able to try other fluids as well as water. Once you are able to drink without being sick, your drip and nasogastric tube can come out. You will then be able to start taking a light diet. For some people your diet may change permanently as you may not be able to cope with large amounts of food and drink any more. The hospital dietician will be able to advise you about this.

Some people have diarrhoea after gallbladder surgery. There is more about this in the diet after gallbladder surgery section

 

Your wound

When you wake up from the anaesthetic, you will have a dressing on your wound. Your nurse will leave this on for a couple of days. Then they will change the dressings and clean the wound. You will have the wound drains in place until they stop draining fluid. Your nurse will change the bottles attached to them every day. Wound drains can usually come out about 3 to 7 days after your operation. Most surgeons now use stitches that dissolve away by themselves once your wound has healed. But if you have stitches or clips that have to be removed, they will be left in for at least 10 days and taken out before you go home. Sometimes, if the wound is not quite healed, but you are otherwise well, you can go home with the clips or stitches in. You will have to come back to the hospital to have them taken out. Or a district nurse may visit you at home and take them out there.

 

Getting up

This may seem impossible at first. Moving about helps you to get better, but you will need to start very gradually. Your physiotherapist will visit you every day after your operation to help you with your breathing and leg exercises. Your nurses will encourage you to get out of bed and sit in a chair 1 or 2 days after your surgery. They will help you with all the drips and drains. Over the next couple of days, your tubes, bottles and bags will be ready to come out. Then it will be much easier to move around.

 

Making progress

After a few days you will begin to be up and about. Gradually you will start to feel better. Soon you will be able to eat more. At first you will find it easier to have lots of very small meals rather than 3 large meals a day. The hospital dietician will give you help and advice with managing your diet.

You have had a lot to cope with. First you had your diagnosis with cancer. Now you have had major surgery. You are likely to have times when you feel very down. It is natural to feel tearful after this type of surgery. For most people, this is at its worst about 4 or 5 days after the operation. Try to be patient with yourself while you recover. You will need a lot of support from your doctors and nurses, family and friends.

There is more about living with cancer of the gallbladder in this section.

If you would like to talk to someone outside your own friends and family, look at our page of gallbladder cancer organisations for people who can help and support you. You can also find details of counselling organisations. To find out more about counselling look in our counselling section

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Updated: 22 August 2012