Gallbladder Surgery

Gallbladder Surgery

The gallbladder’s primary function is to act as a storage for bile.  It is located right under the liver and is attached to the main bile duct.  The liver makes bile and secretes it into the main bile duct. From there, bile can pass directly into the small intestine to aid in absorption of fats, or it can be stored in the gallbladder.  When we eat fatty foods, a signal is sent to our gallbladder to squeeze out extra bile, so that we can absorb the fats from our meal.

Diseases of the Gallbladder

Symptomatic Gallstones

Occasionally, cholesterol and bile in the gallbladder can mix together and form gallstones.  If a gallstone blocks the opening of the gallbladder to the bile duct when the gallbladder squeezes, it produces pain and nausea.  This is referred to as biliary colic or symptomatic cholelithiasis (gallstones). Symptoms typically occur within 1-2 hours of eating a fatty meal and resolve without intervention, as the stone falls away from the opening and the blockage is removed. 

Acute Cholecystitis

Acute cholecystitis (inflammation of the gallbladder) occurs when the gallstone blocking the opening to the bile duct does not release and the gallbladder remains obstructed.  In this situation, symptoms do not resolve, and most people will find themselves in the emergency room or their doctor’s office, and then the operating room.

Bile Duct Obstruction and Pancreatitis

Gallstones also cause problems if they migrate out of the gallbladder and into the bile duct, where they can block both the main bile duct and the pancreatic duct.  When the bile duct is blocked, patients can develop yellowing of the skin (jaundice), in addition to nausea and pain. Pancreatitis develops when a gallstone blocks the pancreatic duct.  In addition to removing the gallbladder (the source of the stones), these conditions require removal of any gallstones that remain stuck in the bile duct.

Gallbladder Dysfunction

Some patients may develop symptoms in the absence of gallstones, when the gallbladder squeezing function is decreased.  This is referred to as gallbladder dyskinesia, or biliary dyskinesia. In order to diagnose this problem, a specialized test is performed that measures how well the gallbladder functions in response to hormone stimulation.  In many cases (75-80%), patients will feel improved after having their gallbladder removed; however, some patients may need to undergo further evaluation if their symptoms have not been cured.

Gallbladder Polyps

Polyps are abnormal growths that originate from the inner lining of the gallbladder.  Most polyps do not cause symptoms but removing the gallbladder may be indicated if a polyp is 1cm or larger or demonstrates growth over time.

Gallbladder Tumors

Unfortunately, like other organs, cancer can originate from the gallbladder.  When diagnosed at early stages, removing the gallbladder can offer the greatest chance for cure.  In some instances, removing a portion of the liver and bile duct may be indicated as well.

Risk Factors for Gallbladder Disease

Classic risk factors for developing gallstones and gallbladder disease include the following:

  • Women
  • 40 years old and older
  • Women who have been pregnant
  • Overweight

Although no specific gene has been identified for developing gallbladder problems, certain populations have been noted to have an increased incidence of gallbladder diseases and may be seen in families.

Signs and Symptoms

  • Abdominal pain after eating, typically located in the middle of the upper abdomen or right side of the upper abdomen
  • Pain may radiate around the side towards the back
  • Nausea and/or vomiting
  • Heartburn or indigestion

Surgery

Removing the gallbladder is most commonly performed with minimally invasive surgery, using laparoscopy or robotics, and four small incisions.  Surgery lasts approximately one hour.  Some patients may go home the same day of surgery, and others may require one-night hospitalization.  After surgery, patients can resume their normal daily activities with minimal restrictions.  Few patients may experience diarrhea after having their gallbladder removed, but most do not. Of those who do, diarrhea typically resolves with time.  Most patients feel completely recovered and are back to normal activity by 1-2 weeks after surgery.

Robotic Gallbladder Surgery Ramsey

If a patient detects any of the signs and symptoms mentioned, the next step should be seeking medical assistance. The decorated Dr. Anthony Pozzessere welcomes all patients to his clinic in Ramsey, New Jersey.