What is the Gallbladder?
The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Once bile is made by the liver, it gets stored in the gallbladder. When you eat, the stomach sends a signal to the gallbladder. The gallbladder contracts, bile is expelled and moves down the main common duct to enter the intestine. Once there, bile mixes with food, aiding in digestion. Removal of the gallbladder is not associated with any impairment of digestion in most people.
Why did I get Gallstones?
No one knows exactly why people get gallstones. We know there are certain risk factors for developing gallstones. They are:
- Women—especially women who are pregnant, use hormone replacement therapy, or take birth control pills
- People over age 60
- American Indians
- Mexican Americans
- Overweight or obese men and women
- People who fast or lose a lot of weight quickly
- People with a family history of gallstones
- People with diabetes
- People who take cholesterol-lowering drugs
What are the symptoms of Gallstones or Gallbladder Disease?
As gallstones move into the bile ducts and create blockage, pressure increases in the gallbladder and one or more symptoms may occur. Symptoms of blocked bile ducts are often called a gallbladder “attack” because they occur suddenly. Gallbladder attacks often follow fatty meals, and they may occur during the night. A typical attack can cause:
- Steady pain in the right upper abdomen that increases rapidly and lasts from 30 minutes to several hours
- Pain in the back between the shoulder blades
- Pain under the right shoulder
Although these attacks often pass as gallstones move, your gallbladder can become infected and rupture if a blockage remains.
Many people with gallstones have no symptoms; these gallstones are called “silent stones.” They do not interfere with gallbladder, liver, or pancreas function and do not need treatment.
How do I know if I have a gallbladder problem?
If you have been experiencing any of the above symptoms you should see your primary care physician. They may refer you to a gastroenterologist first or to a surgeon directly. The standard work up begins with a detailed history and physical exam. An ultrasound is then performed and you’re hepatic function is tested from a blood sample. If the ultrasound confirms stones you should speak with a surgeon.
How is the surgery done?
Laparoscopic gallbladder surgery (cholecystectomy) removes the gallbladder through several small cuts (incisions) in the abdomen. There may also be a special X-ray procedure called intraoperative cholangiography, which shows the anatomy of the bile ducts.
You will need general anesthesia for this surgery, which usually lasts 2 hours or less.
After surgery, bile flows from the liver (where it is made) through the common bile duct and into the small intestine. Because the gallbladder has been removed, the body can no longer store bile between meals. In most people, this has little or no effect on digestion.
Why is it Done?
Laparoscopic gallbladder surgery is the best method of treating gallstones that cause symptoms, unless there is a reason that the surgery should not be done. Laparoscopic surgery is used most commonly when no factors are present that may complicate the surgery.
What to expect after surgery
You may have gallbladder surgery electively as an outpatient, or you may stay 1 night in the hospital. Most people can return to their normal activities in 2 to 3 days. People who have laparoscopic gallbladder surgery are sore for about a week. But in 2 to 3 weeks they have much less discomfort than people who have open surgery. Typically a low fat diet is recommended for one week after surgery. After that, no special diets or other precautions are needed after surgery.
Single Incision Gallbladder Surgery
Dr. Donkor is an expert in gallbladder surgery and is also able to perform gallbladder surgery through one tiny incision. This is referred to as single incision surgery. Unlike most surgeons who perform the surgery with one technique, Dr. Donkor has a variety of ways that he performs single incision surgery. He is the author of and has given many lectures and presentations on single incision gallbladder surgery.
If you or a loved one is interested gallbladder surgery, please contact us and you have may have a consultation with Dr. Donkor to determine if you are candidate.