Gallbladder surgery: cost, duration and step by step

Gallbladder surgery is performed by cholecystectomy. This surgical treatment involves the removal of the gallbladder and is the most recommended surgery for inflammation and pain in the area caused by gallstones.

Gallbladder surgery, i.e. the surgical removal of the gallbladder, leads to an immediate cessation of pain and infection and, in most cases, will prevent gallstones from forming again. In fact, some of the risks of not having gallbladder surgery or cholecystectomy are continued pain in the area, worsening symptoms, infection or bursting of the gallbladder.

Before covering the reasons why gallbladder surgery is necessary, it is important to mention the two possible techniques for gallbladder removal. Cholecystectomy can be performed laparoscopically or conventionally with open surgery:

• Open gallbladder surgery: Open cholecystectomy is performed through an approximately 6-inch incision in the upper right side of the abdomen. The gallbladder is removed through fat and muscle, and then all the ducts are stapled and the suture is closed.
• Laparoscopic gallbladder surgery: Laparoscopic cholecystectomy is the most common technique for removing the gallbladder. In this surgery, surgical tools and a lighted camera are inserted through several incisions. The abdomen is inflated with carbon dioxide gas so that the organs can be seen and differentiated for successful gallbladder removal.

There is no effective therapeutic alternative to gallstone formation. Therefore, when the gallbladder shows a number of symptoms corresponding to the occurrence of gallstones, it is essential to check for the existence of gallstones. Normally, when the substance in the bile crystallises, it becomes solid and gallstones are formed. Sometimes these stones do not cause any symptoms, but in other cases the gallbladder wall is irritated.

In some cases, the stones move into nearby ducts, which can cause more serious problems and block them. When the flow of bile is disrupted, a number of symptoms can occur causing yellowing of the skin and eyes, dark urine and itching.

What causes gallstones in the gallbladder?

• Having a family history of gallstones
• Being overweight
• Having sickle cell anaemia
• Being pregnant
• Sudden weight loss
• Using oestrogen for menopausal symptoms

Symptoms of gallbladder stones

The most obvious symptom of gallbladder problems is severe pain after a fatty meal. However, some people have only one attack of pain, while others have one after every meal. So, some of the most common symptoms, which make the presence of gallstones in the gallbladder obvious, are:

• Severe pain and discomfort in the upper abdomen. This pain may be intermittent or constant over time.
• Slight pain under the ribs or sternum.
• Discomfort in the back or right shoulder blade.
• Low-grade fever
• Nausea and swelling
• Yellow skin typical of jaundice, if there are gallstones in the bile duct.

To treat gallbladder problems and remove gallstones and prevent new ones from developing, the best option is to remove the gallbladder. This treatment will eliminate the pain and prevent future attacks, and you can rest assured that you will be able to live a full and healthy life without a gallbladder.

However, most adults with gallstones have no symptoms. In fact, 80% of people with gallstones can go up to 20 years without any symptoms. Some people therefore decide to delay surgery because gallstones do not pose an immediate health risk. 

However, it should be take into account that postponing surgery can lead to serious complications, for example:

• Continuous pain and aggravation of symptoms.
• Gallstones move into the bile duct leading to infection or jaundice.
• Gallstones block the pancreatic duct and cause pancreatitis.

As mentioned above, there are two surgical techniques for gallbladder surgery: open gallbladder surgery and laparoscopic gallbladder surgery. 

Gallbladder surgery is a surgical treatment aimed at removing the gallbladder. It is the recommended intervention to eliminate gallbladder pain caused by gallstones. In these cases, removing the stones would not be sufficient, as new stones could form. Therefore, gallbladder surgery becomes the only effective option to eliminate the pain and the formation of future stones. 

As mentioned above, gallbladder surgery can be performed using two surgical techniques: open gallbladder surgery and laparoscopic gallbladder surgery:

• Open gallbladder surgery: through this technique, the surgeon makes an incision of about 6 inches on the upper right side of the abdomen and cuts through the fat and muscle to the gallbladder. Once the gallbladder is removed, the incision is stitched closed and a drain is placed from the inside out and then removed by hospital staff.

• Laparoscopic gallbladder surgery: in order to proceed with the removal of the gallbladder, small incisions are made over which the surgical tools are placed and introduced into the gallbladder. Once there, the abdomen is inflated with carbon dioxide, a harmless gas, to lift the abdominal wall and separate the organs. This allows the surgeon to have a clear view of the gallbladder through the laparoscope.

You may be wondering what determines the choice of one treatment or another, whether one technique is better than the other, or whether a better quality of life is obtained after open gallbladder surgery or with laparoscopic gallbladder surgery. 

It is certain that most gallbladder removals are performed laparoscopically and also that this technique offers greater advantages in terms of safety and recovery than open surgery. Nevertheless, in some cases, it is decided to resort to open gallbladder surgery, for the patient's safety, when any of the following circumstances are present:

• Obesity.
• Pancreatitis. As you know, delaying surgery can be a mistake. Gallstones can move and obstruct the pancreatic duct. In these cases, inflammation of the pancreas would leave no safer option than open gallbladder surgery.
• Pregnancy in the third trimester.
• Severe liver problems. These diseases directly affect the liver, preventing it from working properly.
• Previous surgeries in the same area of the belly.

If gallbladder surgery is performed laparoscopically, the surgeon may switch to an open procedure. However, this is not cause for alarm or means that something has gone wrong. The doctor will make this decision when open gallbladder surgery is safer than laparoscopic gallbladder surgery. 

However, even if the interventional technique changes, the methods for closing the ducts and blood vessels will be the same as in laparoscopic cholecystectomy. Normally, a change of procedure usually occurs when there is a compelling reason, such as heavy bleeding during the laparoscopic operation. 

On the other hand, as we have already pointed out, there is nothing to worry about, since open surgery is the alternative solution when complications arise with laparoscopic gallbladder surgery.

Moreover, there are no differences between the two techniques in terms of mortality risk, complications and operation time. However, there are factors that are more associated with one surgical treatment than the other. Laparoscopic gallbladder surgery results in a shorter hospital stay and a faster recovery than open gallbladder surgery.

As you know, Gallbladder surgery can be performed with conventional/open surgery, or laparoscopic surgery. However, both surgical procedures involve the removal of the gallbladder, usually due to the formation of gallstones.

Gallbladder surgery, also known as cholecystectomy, is performed under general anaesthesia, so during the operation you will be asleep and will not feel any pain or discomfort, as you will not be conscious for the duration of the operation.

Therefore, regardless of whether it is open gallbladder surgery or laparoscopic gallbladder surgery, it will take 1 to 2 hours to perform either surgical procedure.

As with any surgery, once the decision to undergo gallbladder surgery has been made, it is essential to undergo preoperative tests. As you know, the surgery can be performed using two surgical techniques: open gallbladder surgery and laparoscopic gallbladder surgery. 

However, the same preoperative tests are performed for both procedures since both surgical treatments aim to remove the gallbladder, usually due to gallstone formation, although there may be other reasons.

Preoperative tests for gallbladder surgery or cholecystectomy

Operarme includes in its price a complete preoperative study that is indispensable for the successful performance of gallbladder surgery, regardless of whether it is an open or laparoscopic surgical procedure:

• Blood test. This test is used to detect alterations in the red series, which could suspend or postpone the date of the operation. This test also measures the amount of platelets and other blood tests that aid in clotting.
• Electrocardiogram. This test is done to record the heart's activity and check for changes in heart activity that may pose a risk for gallbladder surgery.
• Chest x-ray, as medically indicated. This test allows doctors to visualise both lungs and the lower airway, to rule out possible pathologies.

In addition, the doctor will ask you about your symptoms, so we advise you to make sure you mention the place where the ailments occur, as well as their frequency. It is important that in the preoperative consultation you discuss any health problems, the diet you follow, medical treatment if any, etc. In addition, the specialist will carry out a physical examination in which he/she will be able to press on your abdomen to check if there is pain and where it originates.

Gallbladder surgery can be performed using two surgical techniques: open surgery and laparoscopic surgery. Both procedures involve the removal of the gallbladder due to gallstone formation. Normally, most gallbladder problems are caused by the formation of gallstones. However, in some cases the presence of gallstones in the gallbladder does not cause any symptoms, which is often a reason to postpone gallbladder surgery. 

However, this is often the wrong decision as it can lead to more serious complications. On the one hand, stones can move into the bile duct causing inflammation or jaundice, or on the other hand, they can move into the pancreatic duct and cause pancreatitis.

For this reason, gallbladder surgery becomes the necessary option when gallstones are present. The reason why it is decided to remove the gallbladder and not just remove the gallstones is to eliminate the likelihood of gallstones recurring in the gallbladder. 

Once you decide to undergo gallbladder surgery, you will have a consultation with the anaesthesiologist a few days before the surgery. He or she will explain the medications that will be used to prevent any pain or discomfort during the surgery.

Once the date of the surgery has been set, the only thing left to do is to attend the surgery. On the day of surgery, a member of the team will give you an intravenous line to administer the relevant fluids and medications, which are the same for open gallbladder surgery as for laparoscopic gallbladder surgery. Both procedures are performed under general anaesthesia.

Open gallbladder surgery: step by step

As aforementioned, both this surgery and the laparoscopic procedure are performed under general anaesthesia, so you will not feel any pain as you will be asleep. Once the medication is administered, the open gallbladder surgery will begin:

• First, the surgeon makes an incision, about 10 cm long, in the upper right side of your abdomen, just below your ribs.
• He or she will then cut through the skin and muscles to reach the gallbladder.
• The bile duct and blood vessels leading to the gallbladder are cut.
• Finally, the gallbladder is gently lifted and the organ is removed.

During surgery, an x-ray, called a cholangiogram, may be done to check for stones outside the gallbladder. In this case, the surgeon can remove them with a special instrument.

Open gallbladder surgery takes 1 to 2 hours, in the same way as laparoscopic gallbladder surgery. Below, we explain the laparoscopic process for gallbladder removal.

Laparoscopic gallbladder surgery: step by step

Before the surgery begins, the anaesthesiologist with whom you will have a pre-surgery consultation will administer medication so that you do not feel any pain or discomfort. As you know, this surgery is performed under general anaesthesia. 

Once the general anaesthetic has been administered, the surgery will begin:

• In order to place the laparoscope and instruments, small incisions are made in the abdomen. Using the endoscopic images projected on the monitor, the surgeon is carefully guided to the gallbladder.
• Once inside, carbon dioxide, a harmless gas, is administered to lift the abdominal wall, separate the organs and give a clearer view of the gallbladder through the laparoscope.
• A catheter may be inserted to perform an x-ray, called a cholangiogram or cholangiogram, to check that the stones have not moved from the gallbladder into the duct. If they have, the surgeon will remove them with a special instrument.
• The bile duct and blood vessels are then closed with small clips. These clips help prevent bleeding and bile leakage. The clips are made of titanium or plastic that will not harm your body.
• Finally, the gallbladder is lifted out and removed through one of the incisions. Bile will now flow directly from the liver into the small intestine.

In some cases, the doctor may decide during open surgery to switch to a laparoscopic procedure. This decision does not imply that something has gone wrong: it is considered safer to remove the gallbladder through a larger incision. However, in both surgeries, the ducts and blood vessels will be closed using the same method. The only difference between them is that the incision will be larger, the hospital stay longer, and the recovery process longer.

Operarme includes in the price of gallbladder surgery a series of factors that are associated with the success of the results after the operation. As you know, the company has two surgical procedures for gallbladder removal, so there are some differences in terms of human and financial resources.

However, Operarme has studied and consulted in detail, with the specialists in Gallbladder Surgery, the necessary factors that are needed to perform the gallbladder operation with the best results, as well as to favour the comfort of the patient during the whole process.

Open gallbladder surgery costs €4.590 and Laparoscopic gallbladder surgery costs from 5.490 €. It is important to note that both prices are fixed, with no final surprises and with the option of financing. Next, we detail each of the elements that make up the price in both surgeries:

• Booking of the operating theatre.
• Post-operative care until medical discharge.
• Catering and linen service during the relevant hospital stay.
• Medical fees.
• Anaesthesiologist fees.
• Nursing team fees.
• Surgical material necessary for each operation.

However, there are differences between the hospital stay needed for each procedure:

• In the case of open gallbladder surgery, stay in a room with a spare bed for 3 days.
• In the case of laparoscopic gallbladder surgery, stay in a single room with a spare bed for 2 days.

If you would like to request a free, immediate surgical assessment consultation for open gallbladder surgery or laparoscopic surgery, you can contact us and one of our advisors will arrange it for you immediately.

Operarme has an experienced Patient Service Team, ready to solve any questions you may have regarding the process, as well as to arrange an appointment with the specialist doctor on the date that best suits you.

Therefore, if you would like to request your surgical assessment consultation for open or laparoscopic gallbladder surgery, please contact us by calling at +34 91 141 33 56, filling in our contact form or by clicking on the following image: