Gallbladder removal is often needed when a patient develops gallbladder symptoms.
The most common cause of gallbladder symptoms (including nausea, bloating, belching, upper abdominal pain, foul smelling gas, diarrhea) involves the development of gallstones. Gallstones develop when the bile becomes over concentrated and the water is absorbed leaving behind a solid stone. These stones can block the ducts of the gallbladder and prevent the bile from exiting when the body signals the gallbladder to squeeze.
Many patients present with gallbladder symptoms but no stones are seen on imaging tests. Gallbladder dysfunction that leads to gallbladder symptoms without the presence of gallstones is called biliary dyskinesia and involves the gallbladder ineffectively squeezing when signaled to do so after a fatty meal.
Some patients develop gallbladder emergencies like cholecystitis, cholangitis, or gallstone pancreatitis which involve infection and inflammation usually related to gallstones.
In each of these circumstances, patients with gallbladder symptoms should be evaluated by a specialist and considered for laparoscopic cholecystectomy.
Surgery to remove the gallbladder is completed laparoscopically (laparoscopic cholecystectomy) 99% of the time. General anesthesia is required. This means it is completed with small incisions (usually 4 incisions – each about 1/4″-1/2″ in size) over the upper abdomen. The abdomen is inflated with a gas and the gallbladder duct and artery are clipped with small clips and cut. This allows the gallbladder to be detached from it connections to surrounding structures. The clips that are used are permanent but they are compatible with MRIs and don’t require any special care when going through detectors in the airport. The gallbladder is removed via a small bag that is placed into the belly.
Patients who have a lot of scar tissue in their abdomen from previous surgeries/trauma and those who are very sick at the time of surgery have a higher rate of requiring a larger incision over the gallbladder to remove it safely. Laparoscopic and open surgery both require general anesthesia. Usually the operation is under an hour long but patients are required to come to the hospital about an hour and a half before surgery and stay in the recovery room at the hospital for a couple hours after surgery before heading home.