What To Expect When You Have Your Gallbladder Taken Out

Cholecystectomy (koh-luh-sis-TEK-tuh-me) is one of the most common of all surgical procedures performed on both men and women over the age of 50. A cholecystectomy is the surgical removal of the gallbladder. This surgery is usually performed after a painful attack of gallstones, and usually without a lot of prior planning. 

Knowing when you need to see the doctor is key to minimizing pain and recovery time after a cholecystectomy. For me personally, the symptoms of a gallbladder attack were something that just didn't register with me until I had to be admitted to the hospital on an emergency basis for gallbladder removal surgery.

What Is Your Gallbladder?

The gallbladder is a small holding container for bile that drains from the liver. It is shaped like a pear and sits underneath the liver. What the gallbladder does is to store bile produced by the liver, usually 30 to 60 ml (1/8 to 1/4 cup) of bile), so it can be released in a large amount into the small intestine when you eat fatty foods. When fat reaches the small intestine, sensors in the lining of the small intestine trigger the release of a hormone called cholecystokinin. This hormone tells the gallbladder it is time to send bile to the small intestine to capture fat particles and cholesterol. Fatty acids and cholesterol are actually useful in your body when you are consuming the right amounts, and bile salts keep fat from "floating" to the top of your gut or the surface of the toilet bowl, sparing you diarrhea, really stinky flatulence, and bloating.

What Can Go Wrong With Your Gallbladder?

This fluid would ordinarily carry out excess cholesterol your body doesn't need, or bilirubin, which is a yellow pigment the body makes as it recycles old red blood cells. Bilirubin is what gives urine a yellow color. Particles of cholesterol can stick together and make stones. Bacteria can make stones out of bilirubin. (That's an oversimplification, but it's the general idea.) These stones stop or block the normal flow of bile through the gallbladder so the overall problem gets worse, and they can cause pain.

How Can You Tell When You Have Gallstones?

Studies on cadavers (dead people) indicate that most people don't know they have gallstones. The stones aren't painful for everyone who has them. Gallstones can be extremely painful after they accumulate to a certain point, however.

What your doctor expects is that id the disease progresses, the pain tends to stick around. The symptoms a patient experiences will n no longer be "colicky." The pain becomes constant. The doctor generally expects gallbladder pain to radiate up toward your shoulder.  I personally never manage to have symptoms the way they are supposed to happen, and my pain shot down into my right leg. I thought I had a charlie horse, or maybe I had fractured my knee. Belching and leg pain had me baffled, but a trip to the ER by ambulance (it really hurt) resulted in a helpful diagnosis.

READ Diet After Gallbladder Removal

Gallbladder disease doesn't always show up in the same way in everyone who has it. People who have diabetes may not feel any pain at all. They may just have some kind of weird digestive disturbance until they turn yellow (jaundice can result from the bile backing up) and then green (from bilirubin's breaking down). Younger women may have "acalculous" gallbladder disease, poor circulation of bile without stones, causing fever and symptoms of severe infection without obvious gallbladder pain. However, when in doubt, see a doctor. Don't try to figure your symptoms out entirely on your own. Let your doctor find out what is going on with your gallbladder with the help of an ultrasound, and make your decisions from there.

Weight Gain And Gallbladder Disease

Obesity is of the the biggest risk factors for developing gallstones, as being obese means you have an increased amount of cholesterol in your bile. Junk food diets do the same thing, even in people who are at a healthy BMI. You may be surprised to learn that periods of rapid weight loss can, likewise, increase the risk of gallstone formation, as losing a lot of weight in a short period of time both causes the liver to secrete larger amounts of cholesterol into the bile and can prevent the gallbladder from emptying properly. People who follow the recommended healthy and balanced diet once they have had their cholecystectomy will often find that they experience spontaneous weight loss after gallbladder removal. 

Surgical Treatment Of Gallbladder Disease

In the United States, about 500,000 people a year have gallbladder removal surgery. About 10 percent of the entire population "could" have gallbladder removal surgery if they were properly diagnosed. Gallbladder disease is more common among people of European, Pima (native American), or Hispanic heritage, and more common in women than in men. In the overwhelming majority of gallbladder removal cases, the doctor removes the gallbladder with a minimally invasive surgical technique called a laporoscopy.

Laporoscopy is done with a laparascope. The surgeon cuts (usually) two small incisions, just 3 mm (about 1/8 of an inch) long, in the belly button and another on the right side of the torso. Before the early 1990's, removing the gallbladder required a long incision (about 6 inches/150 mm in some cases, sometimes even longer) and a lot of manipulation of tissues.

The advantage of the laparoscopic surgical approach to gallbladder removal is that there is greatly reduced gallbladder removal recovery time. The procedure has become day surgery, and patients can be sent home from the recovery room. As soon as two weeks after, patients who underwent a laparoscopic cholecystectomy will be able to return to all their normal daily activities, after which all they'll need to do is focus on making the lifestyle changes that will keep them healthy.

However, to get the easier kind of gallbladder removal surgery, there are some things that it doesn't hurt to keep in mind:

• The longer you wait to go to the doctor, the less likely you are to be able to get a laparoscopy. After about 72 hours from an acute gallstone attack, tissues around the gallbladder become inflamed, so that the surgeon can't see what he or she is doing. When this happens, the older, long-incision method may be required.
• Taking Aspirin for your pain usually isn't a good idea. Even working through the "keyhole," the surgeon still has to tie off blood vessels as they are bleeding. If you take medications that increase bleeding, you give your surgeon more to do.
• If you have had previous abdominal surgery, scar tissue may make it impossible to use the keyhole technique. 
• If you are a man, it is more likely (although not very likely, the risk is usually reported as 1.5 to 15 percent) that your doctor will have to switch to a long-incision technique during the operation. 

In the process of the surgery, the doctor "blows up" the peritoneum, the layer of connective tissue around the abdominal organs, with a blast of carbon dioxide, inflating it with something like a balloon, so the gallbladder, bile duct, liver, and other organs can be visualized. This procedure has to be done under general anesthesia. When you wake up in recovery, you may look down and wonder if you swallowed a balloon. The area can be swollen, tender, and painful, and you will probably be asked to walk as soon as possible to help move the gas out of your system.

READ Cholecystectomy - Laparoscopic Surgery for Gallbladder Removal