Surgery to treat gallbladder issues
Several main gallbladder problems:
- Stones that develop in the gallbladder, leave the gallbladder, and cause additional problems
- Gallbladder dysfunction: Gallbladder doesn’t empty properly to aid in digestion
Diagnosing gallbladder disease
A right upper quadrant ultrasound used to diagnose gallbladder disease will show:
- The gallbladder anatomy
- Bile ducts and cystic duct draining the gallbladder
An ultrasound might also show inflammation or thickening of the gallbladder wall caused by infection.
You may also be referred for discussion of gallbladder removal if tumors or polyps are growing in the gallbladder. Additional testing may be necessary to determine:
- If the problem is caused by the gallbladder
- If surgical removal would be the treatment of choice
Gallstones in the gallbladder can escape before going down the ducts and blocking the drainage of the liver or pancreas, causing gallstone pancreatitis.
What can surgery do in this case?
Anytime problems happen with the gallbladder, we have to discuss whether surgery is part of the treatment.
Treating gallbladder problems with surgery can:
- Prevent the escape of future stones from the gallbladder
- Serve as treatment for infection or pain caused by gallbladder dysfunction, also known as biliary dyskinesia
The gallbladder is typically removed through laparoscopic surgery, where small incisions and cameras are involved. Sometimes an open cholecystectomy with a larger incision is performed.
What happens during surgery?
When instruments are put into a patient’s body, the goals are:
- Identifying the gallbladder
- Dividing the cystic duct that drains the gallbladder down to the common bile duct
- Removing the gallbladder from underneath the liver
The surgeon might perform a test called an intraoperative cholangiography to identify that anatomy. A cholangiogram involves:
- A catheter being inserted into the cystic duct
- An x-ray dye injected down that catheter
- An x-ray is then taken, which shows the dye traveling in the ducts. This helps to identify the anatomy
An interpretive cholangiogram might also be performed to ensure that there’s no blockage of the ducts.
Once the gallbladder is removed through laparoscopic surgery, it usually takes one to two weeks before patients are ready to partake in most activities and return to work. A patient might need six weeks to fully recover if an open incision was performed.
While your body is adjusting to the absence of a gallbladder, it is not uncommon to experience diarrhea or loose stools, especially after ingesting fatty foods. We advise patients to be more conscious about their diet during the initial recovery stages. Typically, the body is able to compensate for a gallbladder removal and eventually digest fatty foods without much difficulty.
We encourage patients to call us if they have any questions or concerns such as fevers that develop, yellow jaundice, and if the diarrhea significantly interferes with their ability to eat or maintain adequate hydration. We would be happy to see you if you have any questions about the gallbladder and gallbladder surgery. Your surgeon would take the time to explain all of your individual test results and recommended treatment.