Post-Discharge Instructions for Acute Cholecystitis After Surgery
For uncomplicated acute cholecystitis treated with cholecystectomy, no postoperative antibiotics are required once source control is achieved, and patients should focus on wound monitoring, pain management, activity restrictions, and early recognition of complications. 1, 2
Antibiotic Management After Discharge
Patients with uncomplicated cholecystitis (Class A or B) do not require postoperative antibiotics after successful cholecystectomy, as the infection source has been controlled surgically. 1, 2
Patients with complicated cholecystitis require short-course postoperative antibiotics (1-4 days) if they were Class A or B, while Class C patients need longer antibiotic therapy based on clinical response. 1, 3
Continue prescribed antibiotics (oxycodone, ondansetron, acetaminophen) exactly as directed and complete the full course if antibiotics were prescribed for complicated disease. 3
Antibiotic duration beyond 7 days warrants further investigation for ongoing infection or complications. 3
Wound Care and Infection Monitoring
Critical warning signs requiring immediate provider contact include: 1
- Increased drainage, bleeding, or foul odor from incision - may indicate surgical site infection
- Progressive redness, warmth, swelling, or hardness around the wound - signs of cellulitis or abscess formation
- Incision separation or staples/stitches coming apart - requires urgent surgical evaluation
- Purulent drainage from the incision - indicates active infection
Pain Management Considerations
Oxycodone should be taken as prescribed for severe pain, but patients must avoid alcohol consumption while on opioid medications. 1
Pain medications cause constipation - drink plenty of fluids and use over-the-counter stool softeners proactively. 1
Uncontrolled pain despite medication requires immediate provider contact, as this may indicate complications such as bile leak, abscess, or retained stones. 1
Keep all opioid medications in original pharmacy bottles with lids closed and away from children, family, and pets. 1
Activity and Lifting Restrictions
Maintain 15-pound lifting restriction until cleared by your provider, typically for 2-4 weeks post-laparoscopic cholecystectomy. 2, 4
No driving until cleared by provider, especially while taking opioid pain medications. 1
Early mobilization is encouraged but avoid strenuous activities that increase intra-abdominal pressure. 4
Systemic Warning Signs Requiring Immediate Contact
Fever above 101°F (38.3°C) or chills - may indicate intra-abdominal infection, bile leak, or abscess formation requiring imaging and possible intervention. 1
Severe lightheadedness or dizziness - could indicate internal bleeding, dehydration, or medication side effects. 1
Increasing confusion, irritability, slurred speech, or extreme drowsiness - may represent sepsis, medication toxicity, or metabolic derangement. 1
Jaundice (yellowing of skin/eyes) or dark urine - suggests bile duct injury or retained common bile duct stones requiring urgent evaluation. 1
Dietary Progression
Follow regular diet as tolerated but advance gradually from clear liquids to solid foods over 24-48 hours. 4
Some patients experience temporary fat intolerance after cholecystectomy; if diarrhea occurs, reduce dietary fat intake temporarily. 4
Maintain adequate hydration especially while taking opioid pain medications to prevent constipation. 1
Follow-Up Care Priorities
Attend scheduled follow-up with trauma surgery to assess wound healing and ensure complete recovery. 2, 4
Primary care provider follow-up is essential for medication reconciliation and management of underlying conditions. 4
Pathology results should be reviewed at follow-up to confirm diagnosis and rule out unexpected findings such as gallbladder cancer. 4
Medication Safety and Disposal
Safely dispose of unused opioids by contacting your local pharmacy for take-back programs or finding local medicine take-back sites. 1
Never share prescription medications with others, as opioids carry significant risks. 1
If unable to obtain prescribed medications, contact your provider immediately rather than missing doses. 1
Special Considerations for High-Risk Patients
Immunocompromised patients or those with healthcare-associated infections may have received broader antibiotic coverage and require closer monitoring for resistant organisms or opportunistic infections. 1
Elderly patients should be monitored more closely for complications, as they have higher rates of complicated cholecystitis and acalculous disease. 1
Patients with multiple comorbidities who underwent percutaneous cholecystostomy instead of cholecystectomy require tube care instructions and eventual interval cholecystectomy planning. 1