Gallbladder Surgery

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The gallbladder is a sac located under the liver. It stores and concentrates bile produced in the liver. Bile aids in the digestion of fats, and is released from the gallbladder into the upper small intestine (duodenum) in response to food, especially fats.

Types of gallbladder disease include:

  1. Cholecystitis (inflammation of the gallbladder)
  2. Cholelithiasis (gallstones)

You can have gallstones without any symptoms. However, if the stones are large, they can block the duct that leads from the gallbladder. This can cause pain and require treatment. At first they may block the duct and move away, causing only occasional pain. Continuous blockage of the duct, however, can be life threatening and requires surgical removal of the gallbladder. Prompt diagnosis and treatment is key to excellent outcomes.

Signs and Symptoms

  1. Pain, mostly on the upper right side of the abdomen
  2. Pain following meals, intolerance of fatty foods
  3. Nausea, vomiting
  4. Loss of appetite

What Causes It?

A gallbladder attack usually happens because a stone is blocking a passageway in the gallbladder. Gallstones develop in the gallbladder when substances in bile form hard particles. They can be as small as a grain of sand or as large as a golf ball. Women are at higher risk of developing gallstones than men, and the risk increases the more children a woman has had. However, the increased risk associated with having children can be offset by breastfeeding. Women who use hormone replacement therapy are also at higher risk of developing gallstones. Being overweight and rapid weight loss followed by weight gain are other risk factors for gallstones.

What to Expect at Your Doctor’s Office

If you are having a gallbladder attack, you will feel tenderness when the upper right side of your abdomen is touched. Jaundice (yellowing of the skin) occurs when the bile duct (a tube between the liver and gallbladder) is also blocked. Often there is associated nausea, vomiting, and fever. If your health care provider thinks you have a gallstone, you will probably need an ultrasound. During an ultrasound, sound waves take pictures of your gallbladder. This test is painless and can be performed quickly, which is important if you are in a lot of pain.

Treatment Options

Gallbladders that cause pain are usually removed. With modern surgical techniques this is an outpatient and safe procedure. There are no known problems caused by living without a gallbladder. Today, most gallbladder surgeries are performed with a laparoscope. This instrument shows the surgeon pictures of your gallbladder as it is being removed. The minimally invasive procedure allows for a smaller incision and a shorter hospital stay than traditional surgery.

Some drugs can dissolve stones, eliminating the need for surgery. They include:

  1. An oral bile acid, ursodeoxycholic acid (Ursodiol), can dissolve cholesterol stones that are quite small (less than 15 mm in diameter). The drug is successful in about 40% of patients.
  2. Methyl tert-butyl ether and monooctanoin (Moctanin) are solvents that are infused directly into the bile duct or the gallbladder to dissolve stones.
  3. Doctors may use shock wave therapy (lithotripsy) to break up stones.

However, it can take 2 years for a stone to dissolve, and gallstones often come back later.

Following Up

Early surgery usually ends symptoms and recurrence. Stones may appear again in the bile duct, however, but this is quite rare.

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