Gallbladder Surgery

Approximately 800,000 people in America have their gallbladders removed every year. Is it necessary? Certainly, not that often. Sometimes it is absolutely necessary, but not always. How do you know for sure? That’s not easy to determine.

Most doctors advise gallbladder removal with any diagnosis of a gallbladder problem – large gallstones, small gallstones, low-functioning gallbladder, few symptoms, or no symptoms.

If the diagnosis warrants surgery, you are advised to take it out. But the same diagnosis in thousands of people does not mean the same condition exists.

For example, gallstones can be silent which means you are unaware of any problem going on. There are no symptoms at all and the gallstones are found by routine lab tests done for a separate issue. You may eventually develop symptoms or you could live a long life and never experience any symptoms of gallstones.

Or you may be one of those people who have frequent attacks and ongoing gallbladder pain who just can’t live with it. The majority of people we hear from here at GallbladderAttack.com are in the middle. They’ve had an attack; it’s behind them now, but they still have discomfort that gets worse when they are under stress or when they eat the wrong foods. If you are in that camp, you have a choice to make. Part of that choice involves whether or not you are willing to make both lifestyle and dietary changes.

If you do opt for gallbladder removal, will your digestion be perfect afterward? That’s what everybody’s hoping for – to be pain-free, gas-free, bloat-free, and to be able to eat whatever you like. You have a 60% chance of that happening. Out of every 10 cholecystectomies, 4 people will still have symptoms. Those symptoms are rarely, if ever, equal to that of the previous gallbladder attack. They are more often discomfort. But then, there are also those few who end up in worse pain than before surgery.

So, do the research, find out about all the different possibilities, and read about testimonials from others who have been through the procedure before you give your body parts up. It’s not unusual to experience uncomfortable symptoms for a few months after surgery but most of them resolve within a year. Other symptoms, however, can show up years later.

Will I Have Symptoms After Gallbladder Removal?

Some do, and some don’t. But often digestive symptoms that show up down the road can be traced back to a lack of a gallbladder. Educate yourself about the possible symptoms after gallbladder removal.

Can I Function Without A Gallbladder?

Yes you can. The bile will still be produced in the liver and find its way to the small intestine. It will continue to break down your dietary fats and to remove toxins from the liver. The difference is that the bile will no longer be as concentrated (the gallbladder removes 90% of the water from the bile) and its function as a regulator will be gone. Some people have no problem with this at all; others have problems with getting the right amount of bile at the right time, either too much or too little.

Is Gallbladder Surgery Effective?

What is meant by effective? Will you never have another gallbladder attack? I mean, how could you if you have no gallbladder, right? Will you never suffer from indigestion again? Will your gas and bloating disappear? Will your constipation go away? Will diarrhea resolve?

The answer to all of the above is “sometimes”. Actual attacks are rare, but other forms of side effects and discomfort are possible and new symptoms can also develop.

Let’s look at gallbladder attacks. Attacks can come from a low-functioning gallbladder, a hyperkinetic gallbladder, or a gallbladder spasm. But most common and most well-known are gallstone attacks.

Gallstones can also be found in the liver and the bile ducts leading to the gallbladder. In this case, the attack will be caused by a stone blocking a duct. And yes, this can still happen. As seen by the research above, stones are formed partly due to what we eat.

If we take the gallbladder out and continue to eat the same lithogenic (stone-forming) diet that we did before, why should stones not form? They will. You may never know it as you may be asymptomatic for the rest of your life. Or, you may get a stone stuck in a bile duct and experience another painful attack.

This is one of the reasons for the most frequently asked question on this site: “I had my gallbladder removed months (or years) ago. Why do I still have pain?” (See testimonials for examples.)

Removing the gallbladder does not always address the problem in the body that is causing these or other symptoms listed above. It has probably taken years for your body to form these stones. Your fat digestion has been impaired for a long time.

In order to break down and digest fats, your body must produce bile, which is done in the liver. To address the root of the problem, you must study and reflect on the causes of gallbladder disease. There could be an underlying thyroid problem that research connects with both gallstones and a low-functioning gallbladder. Food allergies may also be a big part of it and stress as well.

Another thing to keep in mind is that you could have another gallbladder disease that has not yet been diagnosed. For example, if an ultrasound is done and gallstones are found, a cholecystectomy or gallbladder surgery will be recommended without doing any further exploration.

However, if your gallbladder is ejecting bile below 33%-40% which is considered the normal range, you would be diagnosed with a low-functioning gallbladder or biliary dyskinesia. This can only be determined with a HIDA scan which is an invasive procedure using radioactive dye. Symptoms of biliary dyskinesia are not always resolved with gallbladder surgery either for various known and unknown reasons. One reason is that the problem could be with the Sphincter of Oddi rather than the gallbladder itself.

When Should The Gallbladder Be Removed?

Many doctors recommend gallbladder surgery if you have had only one attack. Others will do so if you have repeated attacks. Some will do so if you have stones; while others will say that you can leave it unless you are having attacks with the stones. This is a place to get a second opinion and above all, to educate yourself; read all you can.

If your doctor finds that you have an infected gallbladder, it will almost certainly have to come out. If it bursts, you are in similar danger as with a burst appendix. Infection is then spread all over the peritoneal cavity. This is like an explosion of infection from a place of containment to the body at large and is difficult to clean up.

If you have a motility problem or a problem with gallbladder contraction or a low-functioning gallbladder, gallbladder surgery might also be recommended. Yet other doctors do not recommend gallbladder removal for biliary dyskinesia.

Regardless of anyone else’s opinion, you are the one ultimately who needs to decide. Only you know when the time feels right and despite attempts to turn things around, it just needs to come out.

So, in conclusion, your best bet may be to try and fix what is wrong if that is possible, before taking it out. If all else fails, then maybe it’s time to consider the surgery route.

References:

(1)Torsoli A, Corazziari E, Habib FI, Cicala M. Scand J Gastroenterol Suppl. 1990;175:52-7 Pressure relationships within the human bile tract. Normal and abnormal physiology.

(2) Shaffer E., Dig Liver Dis. 2003 Jul;35 Suppl 3:S20-5

(3) Surgical Endoscopy Publisher: Springer New York ISSN: 0930-2794 (Paper) 1432-2218 (Online) DOI: 10.1007/BF00188454Issue: Volume 9, Number 9 Date: September 1995 Pages: 977 - 980

(4)Bates T; Ebbs SR; Harrison M; A'Hern RP.Influence of cholecystectomy on symptoms. Br J Surg. 78(8):964-7, 1991 Aug.

(5)E Ros, D Zambon Postcholecystectomy symptoms. A prospective study of gall stone patients before and two years after surgery. 1987 BMJ Publishing Group Ltd & British Society of Gastroenterology

(6)S Hearing, L Thomas, K Heaton, L Hunt Post-cholecystectomy diarrhoea: a running commentary Copyright © 1999 BMJ Publishing Group Ltd & British Society of Gastroenterology.

(7)CAROLE MACARON, MD, MOHAMMED A. QADEER, MD, MPH, JOHN J. VARGO, MD, MPH, Cleveland Clinic Journal of Medicine March 2011 vol. 78 3 171-178, Recurrent abdominal pain after laparoscopic cholecystectomyVetrhus M,

(8)Pain persists in many patients five years after removal of the gallbladder: observations from two randomized controlled trials of symptomatic, noncomplicated gallstone disease and acute cholecystitis., Berhane T, Søreide O, Søndenaa K, J Gastrointest Surg. 2005 Jul-Aug; 9(6):826-31.