How long does it take to recover from gallbladder removal

The recovery time after gallbladder surgery can vary, depending on the type of surgery you are having. Although there are some general postoperative guidelines that apply to most surgical procedures, the number of days in the hospital, the time that it takes to return to normal activities, and other recovery factors will differ.

For example, after a minimally invasive/laparoscopic surgery (provided there are no complications) a person is often discharged the same day or the following day. The hospital stay after open surgery (traditional surgery, involving a large incision) is two to four days longer, and overall recovery takes longer as well.

A person's recovery time can also depend on what type of cholecystectomy (removal of the gallbladder) is performed.

Surgery Follow-Up

After gallbladder surgery, it’s important to follow up with your surgeon in two to three weeks after you are discharged. There are some situations in which you should see your family healthcare provider or surgeon sooner than two weeks.

If you have any of these symptoms, contact your healthcare provider right away:

• Fever over 101 degrees F
• Severe pain
• Swelling in the abdomen
• Jaundice (a yellowish tinge to the skin or the whites of the eyes)
• Nausea or vomiting
• Inability to eat or drink
• Bleeding or pus around the surgical site/s
• Redness surrounding the surgical site/s (that worsens or spreads)
• Pain that is unrelieved by pain medication
• Breathing problems
• A cough the does not improve
• Gray bowel movements

Recovery Timeline

The recovery time varies depending on the type of surgery performed. For example, recovery is much faster for a simple cholecystectomy (removal of the gallbladder only) compared to a radical cholecystectomy (a gallbladder removal procedure often performed to treat cancer, involving the removal of the gallbladder, part of the liver and adjacent lymph nodes).

You can go up and down stairs on the day of your surgery. The next day, you may take your bandages off and take a shower.

You can expect to feel a little better each day after going home. If not, consult with your healthcare provider.

The first few days after you return home:

• You will probably feel weak and tired
• You may have some swelling of the abdomen
• If you had laparoscopic surgery you may have pain in your right shoulder for approximately 24 hours. This is due to the carbon dioxide gas that is inserted into the abdomen (during the procedure) to make space for the surgeon to perform the procedure and to view the surgical site.

24 to 48 hours after surgery:

• You may take your bandages off and shower if your healthcare provider gives you the OK to do so. Be sure to gently pat the incision dry (avoid rubbing it).
• Avoid taking a bath for the first two weeks or until you have your healthcare provider’s approval.

In one to two weeks after surgery:

You may get the OK from your surgeon to return to work and go back to normal activities, if you had laparoscopic surgery, depending on what type of work you do. But it’s important to follow the instructions of your surgeon or family healthcare provider before resuming a normal schedule.

The first two to four weeks after the surgery:

• You may burp often
• You may get diarrhea (it may last two to 4f[ir weeks or longer)

In four to six weeks after surgery:

You may be given the OK to return to work and resume normal activities if you had open surgery. But, be sure to consult with your healthcare provider before resuming normal activities.

Open Surgery Timeline

If your gallbladder removal surgery was performed via an open surgery method, you will need to stay in the hospital a few days after the surgery. Expect to return back to normal activities in around four to six weeks after your procedure.

Recovery time will be slower in other ways as well, for example, your pain may last longer. Your healthcare provider will explain what you should expect in terms of normal recovery time.

Coping

Recovery after a cholecystectomy can be difficult. The level of difficulty in coping is often linked with the reason for your gallbladder surgery (for example, did you have your gallbladder removed due to cancer, or gallstones) and the time it takes to recover.

If you had surgery due to gallstones, the recovery process of regaining your strength and getting back to a normal diet may be challenging. But if you had gallbladder surgery due to cancer or other chronic conditions, there may be quite a long road to recovery.

Pain

After the surgery you will experience pain. The severity of your pain will depend on several factors including your pain tolerance, what type of procedure you had, and more. After laparoscopic surgery, it’s common to experience shoulder pain for the first 24 to 48 hours.

Your surgeon may suggest that you take over-the-counter pain relievers, such as acetaminophen (Tylenol), ibuprofen (Advil or Motrin), or naproxen (Aleve). Using ice on the incision site may help to alleviate pain, but be sure to discuss the best way to use ice with your healthcare provider.

Your surgeon may prescribe narcotic pain medication for the first few days after surgery. If you have any questions about taking pain medications, side effects or other inquiries, be sure to discuss your questions with a healthcare provider.

It’s common to experience some nausea and vomiting from the anesthesia; these symptoms should resolve in a day or two. Narcotic pain medications are likely to worsen nausea and vomiting.

Try taking your pain medication after you eat (unless your healthcare provider advises against it). Be sure to contact your healthcare provider if you are unable to take the pain medication or if your nausea doesn’t resolve itself in a day or two after surgery.

Medications

Your healthcare provider will advise you regarding when to start taking your regular medications again after surgery. If you are on blood thinners (or other medications) and you stopped taking them before surgery, be sure to consult with your surgeon or family healthcare provider about when to resume taking them.

If you were prescribed antibiotics, after surgery, be sure to take the full course, as prescribed; do not stop taking antibiotics when you begin feeling better.

If you are constipated after surgery, consult with your healthcare provider before taking any type of over-the-counter medication. A change of diet, walking as tolerated each day and increasing your intake of water may help alleviate constipation.

Activity 

General guidelines after cholecystectomy include:

• Be sure to rest whenever you feel tired; getting plenty of sleep will promote healing and help you recover.
• Attempt to take a walk each day after surgery. Initially, walk a short distance, then increase the distance (by a little further) each day and gradually increase the distance that you walk. Walking will improve your circulation while helping to prevent pneumonia and promoting normal bowel function.
• Avoid any type of lifting for at least two to four weeks after your surgery (this includes lifting your child, carrying objects such as groceries, a briefcase, backpack, dog food bag, cat litter, a vacuum cleaner, or more).  Again, be sure to follow your surgeon’s instructions on when you can resume lifting heavy objects.
• Avoid any type of strenuous activity, including exercising such as bike riding, running, lifting weights, aerobic or other types of exercise until you get the OK from your healthcare provider.
• Once you stop taking pain medications, you can sit comfortably for relatively long periods of time and you can quickly move your foot from the gas pedal to the brake, it is usually OK to drive, but be sure your healthcare provider has given you the OK before resuming driving.
• Don’t have sex until you get the OK from your healthcare provider.

Diet

After gallbladder surgery, you will slowly increase your diet from a liquid diet to the BRAT diet (including bread, white rice, applesauce, toast, and soda crackers). Then gradually introduce regular solid foods (if your stool is not liquid).

During the time you progress from the BRAT diet to regular foods, be sure to begin looking at labels. Select foods with no more than 3 grams of fat per serving as you start to re-introduce fats into your diet.

It’s common for people to return to eating a normal diet within a month after gallbladder surgery.

When to Call Your Healthcare Provider

There are some symptoms to watch out for that warrant contacting your healthcare provider as you progressively return to a normal diet, these include:

• Severe nausea or vomiting
• Worsening or severe abdominal pain
• Jaundice (yellowish tinge to the skin or whites of the eyes)
• No bowel movement or inability to pass gas for more than three days after surgery
• Diarrhea that lasts more than three days after surgery

A 2017 study found that post-cholecystectomy syndrome (PCS) (symptoms, including upper abdominal pain and indigestion after a cholecystectomy) was associated with eating cholesterol, animal protein, and eggs. The study concluded that eating vegetables did not cause negative symptoms.

A person can live a normal life without a gallbladder, but the gallbladder does help in the digestion of fatty foods. The function of the gallbladder is to store and secrete bile (a greenish-yellow substance that helps breakdown and absorb fats).

After your gallbladder is removed, there may be some changes in your digestion and some symptoms that you should watch for. Your liver will still make and secret bile, but it’s important to carefully watch your diet.

General diet tips after a cholecystectomy include:

• Eat smaller meals more often (instead of large meals).
• Avoid fatty foods for approximately four weeks.
• Try eating bland foods (such as plain white rice, broiled chicken, toast, and yogurt) if you have an upset stomach.
• Drink plenty of fluids (unless contraindicated by the healthcare provider).
• Avoid spicy foods, fatty foods, and alcohol if you have diarrhea.
• If diarrhea continues for longer than two weeks after surgery, consult with your healthcare provider.
• Avoid constipation and straining with bowel movements. Talk to your healthcare provider about what to take for constipation. if you have not had a bowel movement for two or more days after surgery, your healthcare provider may prescribe a mild laxative. Don’t take any type of laxative or other over-the-counter medication without your healthcare provider’s approval.

Diet Progression in Recovery

There are specific types of foods to eat (and those to avoid) while recovering from a cholecystectomy:

• Eat small, frequent meals.
• Avoid fried foods after surgery and limit foods high in fat.
• Avoid foods known to cause a lot of gas (such as beans, cabbage, and asparagus).
• For the initial few days after surgery, eat a clear liquid diet (consisting of broth, gelatin, and other liquids.
• Gradually add solid foods back into your diet.

Foods that are greasy and high in fat can cause pain, bloating and diarrhea after gallbladder surgery; avoid foods that are high in fat including:

• Anything fried in oil such as french fries, fried chicken, fried fish, fried eggs, onion rings, doughnuts, and anything else that is fried
• Meats high in fat (such as sausage, bacon, or high-fat ground beef)
• Whole milk and high-fat dairy (including ice cream, cheese, cottage cheese, cream, and more)
• Pizza
• Lard
• Butter
• Cream-based soups
• Gravy made from meat drippings
• Skin from chicken or turkey
• Chocolate
• Oils (coconut oil, palm oil, and other types of oil)

Convenience foods usually contain unhealthy omega 6 fatty acids (such as from soybean, canola and, sunflower oil) and are not recommended after gallbladder removal. Processed (convenience) foods include foods such as:

• Cakes
• Cookies
• Potato chips (and other types of chips like tortilla chips)
• Crackers
• Store-bought prepackaged baked goods or snack foods (particularly those made with white flour and/or sugar)

Spicy foods can also wreak havoc with your digestive system after gallbladder surgery; eliminate spicy from your diet to avoid gastrointestinal (GI) discomfort.

Slowly increase your diet from a liquid diet, to the BRAT diet (including bread, white rice, applesauce, toast, and soda crackers). Then gradually introduce regular solid foods (if your stool is not liquid).

During the time you progress from the BRAT diet to regular foods, be sure to begin looking at labels. Select foods with no more than 3 grams of fat per serving as you start to re-introduce fats into your diet.

Unhealthy Fats vs. Healthy Fats

The body’s absorption of fat is compromised after the gallbladder is removed; therefore it’s important to limit your intake of foods that are high in omega 6 fatty acids (the type of fat that most people on the Western diet get too much of) and focus on eating more foods rich in omega 3 fatty acids.

Omega 6 fatty acid foods to avoid include vegetable oils such as:

• Canola oil
• Sunflower or Safflower oil
• Corn oil
• Grapeseed oil
• Lard or shortening
• Soybean oil

Vegetable oils high in omega 6 fatty acids are found in processed foods as well, hidden sources of vegetable oils in foods that you should avoid include:

• Mayonnaise
• Salad dressings (store-bought)

Omega 3 Fatty Acids (Healthy Fats)

Healthy omega 3 fatty acids should be prioritized after gallbladder surgery, they can be found in these foods:

• Fish (wild-caught selections of sardines, oysters, salmon, cod, herring, sardines, and anchovies)
• Nuts (such as walnuts and almonds)
• Supplements (including fish oil supplements, cod liver oil, krill oil)
• Other sources (such as flax seeds, chia seeds, and avocados)

Reintroducing new foods too quickly can result in gas, bloating, and abdominal cramps; gradually reintroduce foods that are high in fiber, such as:

• Whole grains (including whole grain bread, quinoa, brown rice, oats, and more)
• Legumes
• Nuts and seeds
• Beans
• Vegetables (such as cauliflower, broccoli, cabbage, and Brussels sprouts)

Keep a Food Journal

Keep track of the foods you eat in writing. Keeping a food journal will help you to remember which foods you’ve recently reintroduced, which cause GI upset, and which ones don’t cause any digestive problems.

Emotional

It’s important to learn to take care of yourself. Reach out when you need help (both physically and emotionally). Strive to implement self-care techniques every day (such as mindfulness, meditation practice, or deep breathing/relaxation techniques).

Oncolink, a website aimed at educating patients and healthcare practitioners about cancer, recommends deep breathing exercises after gallbladder surgery; deep breathing can offer many health benefits, including:

• Helping with pain management
• Keeping the lungs healthy after anesthesia
• Promoting good drainage of lymphatic fluid
• Lending itself to relaxation and lowering stress and tension.

Oncolink suggests closing your eyes while sitting in a comfortable position, taking five to 10 slow, deep breaths, relaxing your muscles, slowly rolling your head and shoulders. This deep breathing exercise should be done a few times each day and any time you feel tense, particularly in the first week after surgery.

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