Gallbladder Attacks: Is It Time For Surgery?

By Gail M. Wynn, MD, FACS, Medical Director,

Saint Francis Bariatric Surgery MBSAQIP Accredited Comprehensive Center 

Most people are unaware they have gallstones until they experience the symptoms, which are very hard to ignore. Gallstones cause moderate to severe pain in the center of the abdomen, otherwise known as a gallbladder attack. Other symptoms may include sweating, nausea and vomiting.

How are gallstones formed?

The gallbladder is a tiny, pear-shaped organ that sits under the liver. It stores bile, a liquid produced by the liver, to help your body digest fat. When bile is needed, the gallbladder will push the liquid to a common bile duct, which then sends it to the small intestines for digestion. Bile is made up of cholesterol, water, bile salts, bilirubin and other components necessary to aid in digestion. When the bile becomes too concentrated with one of these components, tiny crystals, called gallstones, are formed. Gallstones block the flow of bile out of the gallbladder, resulting in a gallbladder attack.

What are the risk factors?

You are most at risk of having gallstones if you:

• Are age 40 or older

• Have Diabetes, Crohn’s Disease or Irritable Bowel Syndrome (IBS)

• Are overweight or obese

• Are a woman

Gallstones are more prevalent in women than in men, mainly due to estrogen, which increases cholesterol levels in bile and decreases gallbladder movement. Excess estrogen during pregnancy can put women at an even higher risk.

Can you prevent gallstones?

There isn’t much you can do to prevent gallstones, but avoiding high-cholesterol foods can help lower your risk. Gradual weight loss may also help.

How do you treat gallstones?

Non-Invasive Treatment

After experiencing an attack, your physician may want to wait to see if the episode returns. In some instances, all it takes is time for the stone to dissolve or to become dislodged. If you continue to experience pain, your doctor may prescribe medication to dissolve the stones. It can take months or even years for the gallstones to dissolve, and in some cases it may not work depending on the type of stone. Shock wave therapy may also be used to break up the stones.

Laparoscopic Gallbladder Surgery

Surgery is the only way to ensure you won’t develop gallstones in the future. The most common surgery performed is a laparoscopic cholecystectomy. During your surgery, your physician will make tiny incisions into the abdomen and fill it with carbon dioxide so it is easier to see all of the organs, and there is more room to work. A tiny microscope and video camera will be inserted to help guide your surgeon while she or he uses instruments to remove the gallbladder from the liver.

After the gallbladder is carefully separated, it is removed through one of the small incisions. At the end of the procedure, the carbon dioxide will be released from your abdomen and the surgeon will close your incisions.

Robotic single-site cholecystectomy is a new way of performing the surgery. This surgery allows the gallbladder to be removed through one incision that is made in the belly button so there are no other visible scars.

Laparoscopic surgery is safe and highly effective, with more than 750,000 patients in the United States undergoing the procedure each year. Patients are usually out of the hospital within two days. Patients are discharged after they are able to eat and drink fluids easily, and are able to walk on their own. After surgery, patients may have bouts of diarrhea and will need to follow a special diet for a few days. Patients should be able to resume a normal life within a week or two.

Open Gallbladder Surgery

A traditional open surgery technique is performed when the laparoscopic method is not possible. It is used on patients who are experiencing complications with blood clotting, inflammation in the gallbladder or obesity. The open technique is similar to laparoscopic surgery, but differs in that it requires an incision to be made under the rib cage to remove the gallbladder. Patients typically spend up to three days in the hospital and require several weeks to recover.

Please call the Saint Francis Bariatric Surgery Center of Excellence at 302.421.4221 to find out if gallbladder surgery is right for you. Don’t forget to mention the article in The Women’s Journal.