Gall Bladder Surgery

Learn about gallstones and gallbladder surgery
What is a gallbladder and what does it do?

The gallbladder is a muscular storage bag for bile, roughly the size of a small pear.  It is attached to your liver, and is on the right side of your tummy, just behind your lower ribs.

Bile is continuously produced by the liver, and it travels down the bile duct into the duodenum. Bile mixes with food and is necessary for normal digestion. It is also stored in the gallbladder. Here it is concentrated and becomes thick. When you eat, your gallbladder squeezes the concentrated bile into your bile duct. This is why the pain from gallstones tends to occur after a meal.

What problems can gallstones cause?
Gallstones are being found more commonly due to the increasing number of scans patients are having for all sorts of reasons.

Simply having gallstones is not a reason to have an operation, because most people will never have problems from their gallstones.

Gallstone symptoms include:

  • Biliary colic: is pain in the upper part of your abdomen, which can last for minutes to hours, after eating fatty meals. 
  • Pain on the right side of your abdomen, lasting for 24hrs+ and feeling feverish
  • Jaundice: where your skin goes yellow and your urine goes dark and your bowel motions are pale. This occurs when a stone escapes from your gallbladder and gets stuck in your bile duct
  • Acute pancreatitis: where you get a severe indigestion type pain in your abdomen, requiring admission to hospital
Can I live normally after having my gallbladder removed?
Yes. Most people notice no difference in themselves, other than the fact they no longer get the pain the gallstones were causing.

Your gallbladder has usually already stopped working long before it ends to be removed.
There are no dietary restrictions once your gallbladder has been removed.
Occasionally patients report that their bowels work more frequently, but this is seldom a problem.

Why did I get gallstones?

There are many risk factors for developing gallstones. They are common:

  • With increasing age
  •  If you are obese or have high cholesterol
  • In women and
  • Seem to run in families

 The number and size of your gallstones  has no relationship to the amount of pain you may feel.

Can gallstones be removed without surgery?
No. Medication has been used to dissolve gallstones. Unfortunately, it causes side effects that patients found even worse than the symptoms caused by gallstones!

Gallstones also return within a few months of stopping the medication.
Shattering gallstones with ultrasound waves has been attempted. Unfortunately, the fragments either join back together or pass into the bile duct causing jaundice or pancreatitis.

Why do I have to have my gallbladder removed, not just the stones?

If only the stones are removed, your gallbladder will make more, and you will have the same trouble all over again. It is therefore pointless to remove only the stones.

How is the gallbladder removed?
This is usually a keyhole surgery operation.
  • Removing your gallbladder is called a cholecystectomy. 
  •  You will have a general anaesthetic.
  • The surgeon will make 4 small cuts on your abdomen, and  “ports” are placed 
  • A Laparoscope and other long thin instruments are then put into your abdomen, via the ports. 
  • Your  surgeon cuts it free of its attachments to the liver and protects your bile ducts.
  •  Your surgeon may take  an x-ray of the bile duct during the operation.
Can I have my operation as a day case?

To be eligible for your Cholecystectomy as a day case, you must be fit and healthy, and have a responsible adult to stay with you for 24hrs. If you have small children you will need to have a second responsible adult to look after them.

While I am waiting to have my gallbladder removed, is there anything I can do to prevent attacks of Biliary colic?

Yes. You need to keep to a very low fat diet. Avoiding butter, full fat milk, cream, cheese, chocolate etc. You should avoid any oily foods, and grill, rather than fry, your food.

Keeping strictly to this sort of diet usually means you will lose weight.
Your General Practitioner may already have given you a supply of strong painkillers to have in reserve should you have another attack of pain. If not, you can ask him/her for some painkillers.

Are there complications of an operation to remove my gallbladder?
Yes. All operations carry a risk. Complications specific to gallbladder removal include:
Bile leak:

This occurs in about 1 in 100 gallbladder operations and is usually diagnosed in the first few days following surgery. This is treated a further keyhole operation through the same scars to inspect the inside of your abdomen, and wash out the bile.

Damage to bowel:

This may occur as a result of the ports being placed or from your bowel being scarred from previous surgery.  This is usually seen at the time of surgery and repaired.

bile duct injury:

This is a serious but rare complication, occurring in around 1 in 500 Cholecystectomies. The damage may be identified at the time of the operation, and repaired. This requires an open operation to repair. However, it may not show up until a  few days, or months after your procedure.

Gallstones in the bile duct:

Small gallstones may pass in to your main bile duct while your gallbladder is being removed. If they get stuck in your bile duct you may become jaundiced, or experience biliary pain again. This occurs in around 1 in 100 Cholecystectomies. This can occur any time after your operation.

If I have my gallbladder and gallstones taken out, will all my symptoms go away?
If your symptoms were due to gallstones, then you will be relieved of your pain.

Gallstones are very common, and you can have them at the same time as a variety of other conditions that cause similar symptoms. So there is always a small chance that removing your gallbladder will not solve your pain.
If we feel that your symptoms are possibly not due to gallstones, we will warn you of this before we remove your gallbladder. We may  order further investigations.

I had an investigation for something else, and I was told I had gallstones, should I have my gallbladder removed?

As a general rule, we don’t recommend surgery to prevent trouble from gallstones. This is because many people have gallstones and live their entire lives without having symptoms.

You may wish to discuss your own particular situation with a specialist.

Will I need a special diet after my gallbladder is removed?

No, there are no restrictions. For the first few days after your operation, you may not have much appetite. We recommend that you have smaller meals until you feel your appetite has fully recovered.

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