Most people are unaware of the gallbladder and its functions while some find the gallbladder as their area of concern. The gallbladder is a small, pear-shaped organ located just beneath the liver. Its role is to store extra bile juice released from the liver. These bile acids help in the breakdown of fatty foods. The bile acid is released from the gallbladder to the small intestine through a connecting tube called the bile duct to digest the fatty food. [1, 2, 3]
Unfortunately, there may be times when the gallbladder is not acting as efficiently as intended, hence affecting one’s general well-being. As a result, there could be a multitude of undesirable consequences such as the build-up of thick bile acids that could create obstructions in the gallbladder and prevent it from getting emptied properly. This could be due to many possible outcomes, most likely of which are gallstones. When this happens, it’s a sure sign to either get the gallbladder issue treated (if minor) or get the organ surgically removed entirely- a procedure called a cholecystectomy. [3]
When do Doctors Recommend Cholecystectomy?
1. Symptomatic Gallstones
Gallstones are the solid bile deposits that form within the gallbladder. They become problematic if they get stuck inside the gallbladder or any of the bile ducts and cause inflammation, infection, nausea, vomiting, bloating, and/or abdominal pain. In some cases, gallstones can lead to biliary colic- a specific kind of pain that is often first felt in the upper right part of the abdomen and sometimes may radiate to the right shoulder or upper back starts in the middle of the night or soon after having a meal, lasts for about 15 minutes or several hours, and may cause nausea and vomiting. If these symptoms appear, it’s an indication to get the gallbladder removed at the earliest or there is a higher risk of severe complications of gallstones.
2. Acute Cholecystitis
It is the inflammation of the gallbladder which is a serious medical condition that can only be treated by surgical removal of the gallbladder.
3. Pancreatitis
When gallstones slip into the bile duct and block it, the pancreatic enzymes are stopped to travel into the small intestine and forced to return to the pancreas. This causes inflammation of the pancreas which in turn could lead to serious health issues. Thus, the best way to treat it would be to completely remove the gallbladder.
4. Cancer of the Gallbladder
Gallbladder cancer is the rarest type of cancer. But, if one is suffering from gallbladder cancer or is at high risk of developing the same, cholecystectomy can be beneficial for survival.
5. Other Gall Bladder Issues
Anyone having choledocholithiasis or Biliary dyskinesia is also recommended for gallbladder removal. Choledocholithiasis is a medical condition wherein the common bile duct contains one or more gallstones. Biliary dyskinesia is a motility or functional disorder of the gallbladder where the organ is not effectively contracting and ejecting the bile acids.[ 2, 3]
Common Signs and Symptoms that Indicate the need for Gallbladder Removal
1. Abdominal Pain
It is the most commonly reported symptom in patients having gallbladder stones that typically occur after eating. The pain can be described as anything from sharp and stabbing to cramping and dull. One may confuse it with pain from gas or acid reflux because of its intermittent nature. However, one must be careful about the potential dangers of any abdominal pain that lasts for several hours.
The abdominal pain due to gallbladder issues is typically felt in the direct center or upper right portion of the abdomen. For some patients, it may extend to the right shoulder blade and the upper back. The pain may be stronger either while having greasy or fatty foods or when taking a deep breath. Immediate medical attention is advised when one is experiencing intense pain such that he/ she cannot sit or find any comfortable position.
2. Digestive Issues
Just like symptoms of many digestive issues, gallstones can lead to symptoms like vomiting, nausea, dark urine, and abnormal color of the stool. If someone is having chronic gallbladder disease, he or she may experience undesirable symptoms such as indigestion, acid reflux, excess gas, and heartburn. These signs may make it difficult for one to distinguish the problem with the gallbladder from other digestive problems. If there are more than four bowel movements on daily basis for at least three months or unexplained fever, it could signal an infection that needs to be treated without much delay.
3. Weight Changes
Obese or overweight people are more likely to have gallstones because weight gain can alter the balance of bile acids and cholesterol in the gallbladder. They would find more difficulty in getting their gallbladder emptied as the excess of cholesterol and bile acids would accumulate in their gallbladder and harden to form gallstones. This means losing weight could surely help one reduce the risk of gallstones, but if weight loss is rapid, it can also trigger gallstones because of the potential imbalance between the levels of cholesterol, bile acids, and lecithin. Usually, this case is seen in people who have undergone bariatric surgery as they tend to lose significant weight in the first 3-6 months and women during and immediately after their pregnancy. Those who desire weight loss must go for daily exercises and a well-balanced diet as extremely low intake of fats in diets can inhibit the contractions of the gallbladder. [1]
How is the Gallbladder Removed?
Laparoscopy cholecystectomy is the minimally invasive procedure to remove the gallbladder. It involves proving general anesthesia to the patient to ensure comfort throughout the surgery. The procedure commences with the making of four small incisions along the abdomen. These cuts are used to insert a laparoscope and other specialized surgical instruments into the abdomen. The abdomen is inflated with gas to provide the surgeon with more inner space to operate better. During the procedure, the surgeon along with his/her supporting team makes use of a tiny camera fitted at end of the laparoscope and a monitor to navigate easily inside the body and operate on the gallbladder. After the removal of the gallbladder, X-rays are taken to ensure that remaining gallstones or bile are not causing any obstructions and the gallbladder is further checked for cancer. [3]
References:
- https://whalenclark.com/warning-signs-you-might-need-your-gallbladder-removed/
- https://www.goodrx.com/conditions/gallstones/signs-you-need-your-gall-bladder-removed
- https://arizonapremiersurgery.com/2020/12/10/warning-signs-you-may-require-gallbladder-surgery/
