The gallbladder is a small hollow bag that stores chemicals (bile made from the liver) used to digest food. When you eat, the gallbladder squeezes out those chemicals into the small bowel to break down the food. The bile travels through bile ducts to the small bowel. It is common for people to get an imbalance of the chemicals in the gallbladder and develop stones. These stones can block the bile ducts and cause symptoms including bloating, abdominal pain, nausea, and vomiting. Sometimes these symptoms are seen in patients without stones because the gallbladder has become dysfunctional. This is called biliary dyskinesia and is due to the gallbladder’s inability to properly squeeze bile which causes pain.
Symptoms of Gall Bladder Disease
- Abdominal pain in the upper right abdomen after a meal
- Right shoulder pain
Patients can sometimes have severe symptoms called an “attack” that causes them to go to the ER. Sometimes this requires surgery within the next day or so, however if you are seen by your primary care doctor for mild symptoms, tests may be ordered to confirm that your symptoms are from the gallbladder. This may include an Ultrasound, Hepatobiliary (HIDA) scan CT or CAT scan or other tests.
Gallstones can cause severe symptoms, but if not removed they can lead to serious complications. Stones can travel into the bile ducts and cause blockage of the liver or the pancreas. This can cause yellowing of the skin, eyes, dark urine and itching (Jaundice). Blockage of the pancreas can cause severe pancreatitis.
Gallbladder removal is called cholecystectomy. Most gallbladders are removed with laparoscopic surgery with small incisions. Laparoscopic surgery is a minimally invasive approach that uses a camera inside the abdomen to help the surgeon perform the surgery. This allows for the patient to return home sooner and faster wound healing. The open gallbladder removal is rarely needed but can be the appropriate surgery in patients with certain other diseases, severe long-term gallbladder disease, or previous surgeries that have caused scaring around the gallbladder.
During surgery, an incision is made near the naval to place the camera. A gas called Carbon Dioxide is used to inflate the abdomen and create space in which the surgeon can operate. Three other small incisions are made to place the dissection instruments and the Gallbladder is removed from under the Liver. The gallbladder is removed through the naval incision and the wounds are closed with absorbable sutures.
Some patients will also need a cholangiogram which involves injecting dye in the bile ducts during surgery to determine if any of the gallstones have traveled out of the gallbladder and into the bile ducts. If stones are found in the ducts an additional procedure after surgery is used to remove them by a Gastroenterologist called ERCP (endoscopic retrograde pancreatography).
When your surgery is complete, you will wake up from the anesthesia in the recovery room for a few hours. You will be able to drink and walk a little before returning home the same day. If your surgery is done laparoscopically, you will likely go home the same day, however if an open surgery is performed, you may need to recover in the hospital for a few days.