Signs You May Need Your Gallbladder Removed
Medically reviewed by Qin Rao, MDMedically reviewed by Qin Rao, MDSurgical removal of the gallbladder (cholecystectomy) is the most commonly performed operation worldwide and is the standard treatment for gallstones that cause symptoms or complications.Gallstones are solid, pebble-like deposits within the gallbladder, a small, pear-shaped organ located in the upper right part of the abdomen. While most people with gallstones do not have symptoms, if symptoms do occur, they involve debilitating attacks of right upper belly pain, nausea, and/or vomiting.Other potential indications for a cholecystectomy include gallbladder cancer, a dysfunctional gallbladder, or gallbladder polyps (abnormal tissue growths).
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What Does the Gallbladder Do?The gallbladder stores bile, a fluid the liver makes that helps break down fat. Normally, the gallbladder contracts during a meal, squeezing bile out through tiny canals called bile ducts into the gut to aid digestion.
Reasons to Get Your Gallbladder RemovedThe main reasons for surgical gallbladder removal are symptomatic gallstones and gallstone-related complications like gallbladder inflammation and infection.Gallstones are predominantly composed of a fatty substance called cholesterol. They form within the gallbladder and can stay there or travel to the bile ducts. In most cases, gallstones cause no symptoms and are found incidentally on imaging tests performed for other reasons.If symptoms are present, the most common initial symptom is belly pain in the right or middle upper part of the abdomen. The pain may travel to the back, usually the right shoulder blade.This pain, termed "biliary colic," has the following features:It is classically triggered by eating a large, fatty meal, although it can occur late at night.It is severe and gnawing within an hour of starting before slowly resolving to a dull, aching sensation that lasts up to six to 12 hours.It is not eased by changing position, having a bowel movement, or passing gas.It is accompanied by nausea and/or vomiting.
Learn More: How to Tell Gallbladder and Liver Pain Apart
Unlike symptomatic but uncomplicated gallstones (which warrant an elective cholecystectomy), complications of gallstones warrant an emergency cholecystectomy.Two common complications of gallstones include:Cholecystitis is gallbladder inflammation caused by a gallstone blocking the duct that drains bile. Symptoms include persistent and severe biliary colic, nausea, vomiting, and fever.Choledocholithiasis is when a gallstone gets lodged in the common bile duct, which carries bile from the liver to the gallbladder. Symptoms include jaundice, pale stools, dark urine, fever, and severe pain in the upper right belly.Gallstone pancreatitis is inflammation of the pancreas caused by a gallstone blocking the pancreatic duct. Symptoms include severe and constant upper abdominal pain that travels to the back, nausea, vomiting, and, in more advanced cases, jaundice (yellowing of the skin and whites of the eyes caused by a buildup of the substance bilirubin in the blood).The above complications are severe and require hospitalization for pain control, intravenous (IV, through the vein) fluids, and sometimes, antibiotics.Gallbladder removal for cholecystitis and gallstone pancreatitis is performed, often during the same hospital stay or very soon after.Depending on various risk factors, a cholecystectomy or ERCP (endoscopic retrograde cholangiopancreatography) is performed for choledocholithiasis.
Seek Emergency Medical AttentionGo to your nearest emergency room if you are experiencing any of the above gallstone-related complications.If not treated immediately, they can progress to life-threatening conditions, including widespread infection and gallbladder perforation (a hole forms in the wall) or gangrene (tissue death).
Besides symptomatic or complicated gallstones, other possible indications for a cholecystectomy are:Acalculous gallbladder disease is inflammation of the gallbladder without gallstones that's typically seen in hospitalized and critically ill people.dyskinesiaBiliary is a functional gallbladder disease that causes biliary colic in the absence of gallstones or gallbladder abnormalities.Gallbladder cancer occurs when cells within the gallbladder grow uncontrollably and abnormally.Gallbladder polyps larger than 10 millimeters warrant surgery.Porcelain gallbladder is a rare condition in which built-up calcium deposits cause a hardening of the inner wall of the gallbladder.What Specialist Performs Gallbladder Removal?Gallbladder surgery is performed by a general surgeon or a gastrointestinal surgeon (a general surgeon specializing in digestive system operations). There are two main approaches to performing a cholecystectomy.Laparoscopic CholecystectomyIn more than 90% of cases, the gallbladder is removed laparoscopically. Laparoscopic cholecystectomy is a minimally invasive surgery in which the surgeon makes three to four small incisions (cuts) in the belly to remove the gallbladder.During the surgery, after the incisions are made, carbon dioxide gas is pumped into the abdomen so that it swells up, allowing the organs to be easily seen.Next, the surgeon inserts a long, thin tool with a tiny camera attached to it into one of the incisions. The camera takes pictures inside the belly, which are projected onto a monitor in the operating room.The surgeon then inserts additional surgical tools through the other incisions to take out the gallbladder.Open CholecystectomyAnother approach is traditional open surgery, in which the gallbladder is removed through one large incision made in the upper right side of the belly.Open cholecystectomy is often reserved for more complicated cases of gallbladder disease like gallbladder cancer or infection, severe inflammation, or scarring within the abdomen, often from prior surgeries.
Laparoscopic vs. Open CholecystectomyLaparoscopic cholecystectomy is the preferred approach for most gallbladder diseases.Compared with open cholecystectomy, laparoscopic cholecystectomy is linked to decreased pain after surgery, shorter hospital stays, and faster recovery and return to daily activities.
Learn More: Cholecystectomy Surgery: Everything You Need to Know
Benefits of Surgical InterventionThe benefits of surgical removal of the gallbladder include:Relief of gallbladder-related symptoms, such as belly pain, nausea, and vomitingA lowered risk of complications like infection or inflammation of nearby bile ducts or organsKeep in mind there is insufficient data to support alternative approaches to managing symptomatic gallstones, like undergoing a gallbladder cleanse or adhering to a low-fat diet.Life Without a GallbladderThe gallbladder is not an essential organ, meaning you can live healthily without it. Once a person's gallbladder is removed, bile moves directly from the liver (where it's made) to the gut.While cholecystectomy usually causes no long-term problems, around 50% of people experience softer, looser stools and/or bloating after surgery. The good news is that these symptoms are generally mild and improve over time, often within a few weeks after surgery.Pain and Symptoms After RemovalRecovery after a cholecystectomy depends on the type of surgery performed, as follows:With laparoscopic cholecystectomy, a person is often able to go home the same day and resume their daily activities within a week.With open cholecystectomy, a hospital stay of up to one week is needed, and a return to normal activities may take up to a month.Immediately after surgery, you can expect the following:Pain, especially around the incision sitesRight shoulder pain if you had laparoscopic surgery (due to the carbon dioxide gas being reabsorbed into the body)Increased gas and burpingFollowing your surgeon's instructions for at-home recovery will help ensure a smooth healing process. These instructions will include information about:How to care for your incision site(s), and when to call for worrisome symptoms/signs (e.g., increased incision site tenderness or redness)The time frame for when you can restart prior medications and resume activities like showering, driving, and returning to workGuidelines for taking newly prescribed medications, like painkillers and sometimes, antibioticsIf diarrhea doesn't improve after surgery, a healthcare provider can give you medications to help with the symptoms.SummaryA cholecystectomy is the surgical removal of the gallbladder. It's most commonly performed as an elective surgery for gallstones that cause symptoms, namely attacks of severe belly pain in the upper right or middle portion of the belly, associated with nausea or vomiting.Emergent cholecystectomy is performed for gallstone complications like gallbladder or pancreas inflammation. Symptoms of these complications can include constant, severe belly pain, fever, and/or jaundice.Surgical removal of the gallbladder is usually performed laparoscopically, which is a minimally invasive approach that involves making three to four small incisions in the abdomen. However, it can also be performed as an open operation, where a larger incision (cut) is made in the abdomen to remove the gallbladder.Since the gallbladder is not an essential organ, people can live full, healthy lives without it. Some people may experience bloating or diarrhea after the surgery, but these symptoms generally improve over time. Read the original article on Verywell Health.
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