Gallbladder Removal / Cholecystectomy
The gallbladder is a small, pear-shaped organ attached to the liver in the upper right quadrant of the abdomen. The gallbladder plays a role in the digestion of food and especially fat. The liver produces bile which then mixes with food in the stomach. The gallbladder acts as a storage pouch for excess bile. It compresses to release additional bile when we eat particularly large or fatty meals. Bye regulating the amount of bile that enters the stomach, the gallbladder allows us to easily eat meals of varying sizes without significant gastrointestinal issues. Think of the gallbladder as a balloon – inflated prior to a meal and deflated right after.
However, the gallbladder can become diseased, and the most common problem associated with it is gallstones. These stones made of hardened cholesterol and can be small or relatively large and vary in number. It is estimated that about 15% of all Americans have gallstones, but of those only about 10% actually experience symptomatic gallstones. Gallstones in and of themselves are not dangerous, however when they start to block the outflow of bile, they can cause significant pain, nausea, vomiting and general malaise. The first few gallstone attacks may be rather mild, but they typically increase in intensity, eventually leading the patient to seek medical treatment. While all abdominal pain should be evaluated by a qualified doctor or general surgeon, pain in the upper right quadrant just under the rib cage is usually a sign of gallbladder disease.
There are many causes of gallstone formation. We do not yet have the ability to predict which patients will develop gallstones. However, those suffering from obesity, those who have lost a significant amount of weight quickly and those who are chronically dehydrated have a higher risk of developing gallstones. Females of childbearing age are also at higher risk.
Treatment for symptomatic gallstones
As mentioned above, millions of Americans have gallstones, however only a small percentage require intervention as we only treat symptomatic cases. And since the gallbladder is not an essential organ, the most effective treatment for gallstones is surgery to remove the entire gallbladder. Other treatments such as “gallbladder flushes,” sound wave therapy, chemical treatments and other alternative options are typically not recommended and are ineffective except in very narrow circumstances. Being that gallbladder surgery is one of the safest and most effective general surgery procedures, most patients will benefit from surgical intervention to improve their lifestyle and eliminate symptoms.
How gallbladder surgery works
The gallbladder is removed using a minimally invasive or laparoscopic technique. A few small incisions are made in the upper abdomen and miniaturized surgical devices including the camera are inserted into the surgical area. This procedure can also be performed robotically. First, Dr. Higa will separate the gallbladder from the liver and identify the important veins and arteries from and to the gallbladder. Using titanium clips, these blood vessels will be sealed off and the gallbladder cut away. The gallbladder is removed through the largest of the incisions in the abdomen and sent to pathology where it is checked for any malignancy.
Risks and considerations of gallbladder surgery
A cholecystectomy is one of the safest general surgery procedures in the world. As such, the risks are typically limited to the inherent risks of a surgical procedure using general anesthesia. Because of the laparoscopic and outpatient nature of the procedure, most patients do not have a significant amount of pain and can leave the surgery center on the same day. Some patients may experience GI upset for a few days after surgery. Patients should refer to their post-operative packet to be on the lookout for infection and other possible complications after any surgery.
In researching gallbladder surgery, you may come across stories of people gaining weight after the procedure. This is certainly possible, but not because of the surgery itself. Rather, the symptoms associated with gallstones are self-limiting and force patients to eat fewer fatty, large meals. As a result, they are better able to maintain their weight. When they are no longer limited by these symptoms, they may eat more and liberalize their diet, causing weight gain.
If you would like to speak to Dr. Higa about abdominal concerns that may be your gallbladder, we invite you to schedule a consultation with our office to learn more about gallbladder surgery and cholecystectomy.