Gallbladder Removal

Overview

Gallbladder removal surgery, also known as a cholecystectomy, is a common procedure performed to help people with gallstones, which can cause severe pain, inflammation or infection.

Surgery to take out the gallbladder is carried out through one of two methods – an open or laparoscopic cholecystectomy. Given that you don’t need a gallbladder to live a healthy life, surgery is often recommended should you develop any problems with it.

What Is the Gallbladder?

The gallbladder is a small, pear-shaped organ that lies in your upper abdomen, just below the liver. Its primary function is to collect and store a liquid called bile, which helps your body break down and digest fatty foods.

The gallbladder is connected to your liver through the common bile duct, and, when you eat, the stored bile in your gallbladder is released into the common bile duct, which then opens into the small intestine and begins breaking down fats.

What Are Gallstones?

Gallstones are small, hardened deposits of digestive fluid in the bile that can form and become stuck in the gallbladder.

Most gallstones form due to excess cholesterol in the bile, and can range in size from a grain of sand to that of a golf ball.

Types and Causes of Gallstones

The precise cause of gallstones is not always clear, however they are usually a result of:

  • Your bile containing too much cholesterol - if your liver discharges more cholesterol than your bile can dissolve, the excess cholesterol may form into yellow cholesterol stones.
  • Your bile containing too much bilirubin - bilirubin is a chemical produced naturally when your liver breaks down old red blood cells, however some conditions, such as liver cirrhosis and certain hereditary blood disorders, can cause an overproduction of bilirubin. This, in turn, can lead to the formation of dark brown or black pigment gallstones.
  • Your gallbladder not emptying correctly - in order to function properly, the gallbladder needs to empty completely and regularly, otherwise bile may become highly concentrated and contribute to the development of gallstones.

  • Other possible causes of gallstones may include:
  • Obesity, particularly in women
  • Excess oestrogen
  • Cholesterol-lowering medications
  • Diabetes
  • Rapid weight loss

  • Symptoms of Gallstones

    In many cases, there may be no obvious signs or symptoms of gallstones - indeed, asymptomatic or "silent stones" are highly common, and may only be detected from an x-ray or during abdomen surgery.

    For those that do notice symptoms, they tend to follow a fatty meal and occur if a gallstone becomes trapped in a duct and causes a blockage, after which you may experience:

  • Sudden, severe abdominal pain, either in the upper right or centre of your abdomen
  • Pain between your shoulder blades or under the right shoulder
  • 
  • Nausea or vomiting
  • Other digestive problems, such as indigestion, heartburn or gas

  • When to see a doctor

    It is important that you seek medical attention if you develop signs of a more serious gallstone complication, such as:

  • Prolonged, intense abdominal pain
  • High fever and chills
  • Yellow skin or eyes (jaundice)
  • Dark urine and light-coloured faeces
  • Diagnosis of Gallstones

    As well as examining your eyes and skin to check for visible changes in colour (that may show an indication of jaundice), a number of tests can be performed in order to diagnose gallstones. These include:

  • Abdominal ultrasound - the most commonly used test to check for signs of gallstones
  • Abdominal CT scan
  • Endoscopic ultrasound
  • Blood tests
  • Do I Need To Have My Gallbladder Removed?

    If your gallstones are not causing you symptoms, gallbladder surgery will not usually be required. However, if a stone enters or blocks one of your bile ducts - causing an intense, sharp and prolonged pain often referred to as a "gallbladder attack" - a surgical removal will be recommended as the most effective treatment available.

    Gallbladder surgery is also undertaken in order to prevent the more serious complications and forms of gallbladder disease that gallstones can give rise to, including cholecystitis (an inflammation of the gallbladder, which can cause nausea and jaundice), as well as an inflammation of the pancreas, or infection.

    What Alternative Treatments Are Available?

    In some cases, particularly those with minor symptoms, they may be treated by cutting back on fatty foods, however a change in diet won't guarantee a prevention of future gallbladder attacks.

    Similarly, certain medications can be prescribed to dissolve gallstones, though it may take months or even years to fully eliminate them. In the event of the medication working, there will remain a possibility of your gallstones returning, especially if you stop taking it.

    How Do I Prepare For a Cholecystectomy?

    Before your gallbladder surgery, your surgeon will have you undergo a number of tests to ensure you are in the right physical condition for the procedure, including:

  • Blood tests
  • Imaging examination of your gallbladder
  • Complete physical exam
  • Review of your medical history

  • It is important that you inform your doctor of whether you are taking any medications or supplements, as you may have to stop taking these prior to your surgery. If you are pregnant or think you may be pregnant, make sure to tell your doctor as well.

    You will also be provided with further instructions in preparation for the day of your surgery, such as:
  • Arranging for someone to pick you up and drive you home
  • Having someone look after you immediately after your surgery
  • Fasting for four or more hours before surgery
  • Showering using an antibacterial soap leading up to your surgery

  • How Is a Cholecystectomy Performed?

    There are two main ways of removing a gallbladder:

    Open cholecystectomy

    An open cholecystectomy involves a single, large incision in your upper abdomen, in order to separate and remove your gallbladder from your liver.

    The procedure takes approximately an hour and is performed under a general anaesthetic.

    Laparoscopic cholecystectomy

    A laparoscopic surgery, also known as a "keyhole surgery", is the more common method of removing a gallbladder as it is a minimally invasive surgery, and as such, is generally associated with reduced pain, less scarring and a quicker recovery.

    During a laparoscopic gallbladder removal, several small incisions are made into the abdomen, allowing the surgeon to insert a thin, flexible tube (port), into which fine surgical instruments along with a telescope can be inserted, so that they can see into your abdomen and remove the gallbladder via the port.

    Like an open surgery, a laparoscopic cholecystectomy is also performed under a general anaesthetic and normally completed in about an hour.

    Risks of Gallbladder Removal

    Both an open and laparoscopic gallbladder removal are considered safe operations, and while any surgical procedure carries possible complications, such as excessive bleeding, infection or injury to the bile ducts, these are highly rare and their risk will be mitigated by the thorough physical examination and review of your medical history your doctor will have you undergo prior to the operation.

    Recovery After Gallbladder Removal Surgery

    Open gallbladder removal

    For an open gallbladder removal, you should be able to go home after 2 to 4 days. A full recovery can be expected in about 4-6 weeks, after which you should be able to return to regular activities and a normal diet.

    Before you are discharged, you will be monitored to ensure you aren't experiencing excessive bleeding, nausea or pain, as well as for signs of infection.

    It is advisable not to engage in any heavy lifting throughout your recovery period, drink plenty of fluids, wash your hands before and after touching around the site of your incision, and to avoid wearing tight clothing that may rub against the incision.

    Laparoscopic gallbladder removal

    As keyhole surgery is rather less invasive than open surgery, most people are able to leave hospital on either the same or following day. A return to regular activities can be expected within a week or two.

    You will be encouraged to walk and begin doing light exercise soon after your surgery, while you'll also be required to wash and look after your incision wounds properly during your recovery.

    FAQs

    What is the cost of the procedure?

    The cost of a gallbladder surgery varies depending on a number of factors, namely the chosen method - an open or laparoscopic gallbladder removal - as well as your level of private health insurance. You may also be covered for part of the surgical fee by Medicare.

    During your consultation, we will provide you with a full explanation of the cost to assist you with your decision. To make an appointment, get in touch with one of our friendly team members.

    When is the follow-up after surgery?

    You will normally be asked to see your surgeon 2-3 weeks after your procedure.

    Can you live without a gallbladder?

    You can lead a perfectly normal and healthy life without a gallbladder.

    Your liver will produce enough bile to digest your food, and rather than being stored in your gallbladder, it will be dripped directly into your digestive tract.

    While most people go back to eating the way they did before after recovering from their surgery, some people may notice a change in their digestion, which can be remedied through medication or certain lifestyle changes, such as adopting a low-fat diet or eating smaller, more frequent meals.

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