General and Gastrointestinal Surgery

Open (Conventional) Surgery Q&A

What does open surgery involve?

In open or conventional cholecystectomy an incision about 6 to 8 inches long is made in the right chest parallel to the rib cage or, alternatively, in the middle of the body from the middle of the rib cage to near the belly button. Once the abdomen is opened, the cystic duct and cystic artery are identified and divided between titanium clips or ties. An x-ray may be done to look for stones in the common bile duct, prior to this. Once these structures are divided, the gallbladder is removed from its attachments to the liver and removed from the abdomen. The abdomen is inspected for bleeding and closed with sutures or clips.

What is the recuperation period for open surgery?

Postoperatively, you are in the hospital for four to six days for convalescence. The primary reason for this is postoperative discomfort. Patients who have less discomfort can often be discharged on the second or third postoperative day.

After discharge the patient can begin to resume normal activities as tolerated without any heavy lifting or driving.  By two weeks most patients can drive and by four to six weeks they can return to work and heavy lifting.

Is open surgery safe?

Open cholecystectomy has been performed for over one hundred years. The first procedure was performed by the German surgeon Carl Langenbuch in 1886. Since then, the safety of this procedure has increased dramatically. The mortality rate is less than 1 in 1,000 if there are no complicating factors such as unstable or severe heart disease. The overall complications of pneumonia, infection, hernia, bleeding, etc., occur in less than 5 percent of patients.  It is one of the safest general surgical procedures performed.

More about the gallbladder and gallstones