Cholecystectomy: Clinical Overview and Physiotherapy Considerations

Introduction

Cholecystectomy is one of the most commonly performed abdominal surgical procedures worldwide. It is primarily done to relieve symptoms and prevent complications arising from gallbladder diseases, especially gallstones. Proper postoperative care and physiotherapy play a vital role in promoting early recovery and functional independence.

Definition

Cholecystectomy is a surgical procedure involving the removal of the gallbladder, a small pear-shaped organ located beneath the liver that stores and concentrates bile for digestion.

Etiology

Cholecystectomy is commonly indicated due to:

• Gallstones (cholelithiasis)
• Gallbladder inflammation or infection
• Acute or chronic cholecystitis
• Biliary dyskinesia
• Gallstone-related complications, such as pancreatitis

Incision Site

• Laparoscopic cholecystectomy: Small incisions (usually 3–4) in the abdomen, including the umbilical region
• Open cholecystectomy: A larger incision below the right costal margin (right upper abdomen)

Procedure

• The surgery is performed under general anesthesia
• In laparoscopic surgery, a camera and specialized instruments are inserted through small incisions
• The gallbladder is carefully dissected and removed
• Open surgery is reserved for complicated cases or when laparoscopy is contraindicated

Signs and Symptoms 

• Right upper abdominal pain
• Nausea and vomiting
• Pain radiating to the back or right shoulder
• Indigestion and bloating
• Fever in cases of infection
• Fatty food intolerance

Complications

• Postoperative pain and shoulder tip pain
• Infection or bleeding
• Injury to the bile ducts or nearby organs
• Bile leakage
• Respiratory complications due to pain and shallow breathing

Physiotherapy Management

Physiotherapy helps in early recovery and prevention of complications:

• Breathing exercises: To prevent atelectasis and pneumonia
• Early mobilization: Decreased risk of deep vein thrombosis
• Gentle mobility exercises: To improve trunk and shoulder movement
• Postural correction: Especially after laparoscopic surgery
• Pain management techniques: Splinted coughing and positioning
• Education: Proper posture, activity modification, and home exercise program

Conclusion

Cholecystectomy is a safe and effective surgical intervention for gallbladder disorders. While surgical management addresses the primary pathology, postoperative physiotherapy remarkably enhances recovery by improving respiratory function, decreasing pain, and restoring mobility. A multidisciplinary approach ensures optimal patient outcomes.