By Jasmine Baker, RN
Ascension Medical Group

The gallbladder is a small, pear-shaped organ on the right side of the abdomen, just below the liver. It functions as a storage unit for bile, an acid that the body uses to break down fats in the small intestine.
Stones can form in the gallbladder or in the bile ducts, blocking the flow of bile to the small intestine. With the flow of bile blocked, the body is not able to digest rich and fatty foods.

When that happens and symptoms are mild, it may be possible to opt for a watchful waiting approach. Some patients are able to stave off future attacks by following a low-fat diet. In most cases, however, surgery to remove the gallbladder is the most effective option. If an ultrasound reveals gallstones, your clinician can recommended laparoscopic surgery.

Many people are surprised to learn that people get along perfectly well without a gallbladder. The gallbladder’s main function is storage plus concentration of bile. After surgery to remove the gallbladder, the bile produced by the liver is delivered directly to the small intestine. The main change is that bile is being delivered on an on-going basis, rather than being stored and delivered when needed for digesting fats.

Gallbladder surgery is one of the most common procedures performed in the United States, with more than 600,000 surgeries performed annually. The majority are performed laparoscopically, a surgery that involves making four small incisions in the abdomen and inserting a scope connected to a camera to guide the procedure via a television screen. The surgeon is then able to cut out and remove the gallbladder through one of the tiny incisions. Any stones lodged in the bile duct are also removed.

The laparoscopic procedure takes from one to two hours and patients are able to return home either the same day or the following day. The small incisions make for a shorter recovery time and less post-operative pain compared with open surgery.

Open surgery involves making a six to seven inch incision in the abdomen and removing the gallbladder as well as gall stones that might be lodged in the bile duct.

After open surgery, patients typically stay in the hospital for two to three days and may be off work from four to six weeks. During that longer recovery period, they need to take it easy while they recover and refrain from strenuous activity and lifting anything heavier than 10 pounds.

Why open surgery? Your surgeon may recommend open surgery if you have severe gallbladder disease that will require removal of gallstones in the bile duct as well as the gallbladder. The presence of scar tissue from previous surgeries and, in some cases, obesity, may also make open surgery the best choice.

There are a number of instances in which the surgeon performs laparoscopic surgery but must revert mid-surgery to an open procedure. Situations when this might occur include the presence of gallstones in the bile duct that also need to be removed or the presence of scar tissue. This happens rarely in younger patients but occurs in up to 30 percent of older male patients.

Doctors usually recommend that patients, after surgery, eat a number of small meals rather than fewer large ones. They often advise gradually increasing the amount of dietary fiber and limiting fat and very sweet foods. As your body recovers from surgery and gets used to the constant flow of bile, it will gradually adjust.

Doctors usually recommend that patients, after surgery, eat a number of small meals rather than fewer large ones. They often advise gradually increasing the amount of dietary fiber and limiting fat and very sweet foods. As your body recovers from surgery and gets used to the constant flow of bile, it will gradually adjust.

It’s common to have some diarrhea for the first few weeks after surgery, which usually resolves. The continuous draining of bile into the small intestine can have a laxative effect. Limiting fat, increasing dietary fiber, eating smaller, more frequent meals and limiting caffeine and dairy intake may help.

Unlike kidney stones that, although painful, can be passed from the body, gallstones do not go away on their own. Surgery is the most effective option for dealing with the pain and discomfort of gallbladder disease. Fortunately, laparoscopic surgery offers patients a low-risk treatment option with a relatively brief recovery time.

Jasmine Baker, RN, is a case manager with Ascension Medical Group.