The gallbladder is a small pear-shaped sac under the liver on the right side of the abdomen. It stores bile produced by the liver. When released into the small intestine, bile helps break down the fats in food.
Gallstones form when the bile crystallises in the gallbladder. They are very common, but in most cases don’t cause any symptoms. However, if a gallstone becomes trapped in a duct inside the gallbladder it can trigger severe and sudden pain that usually lasts between 1-5 hours. The pain can spread from the abdomen to the chest, the back or between the shoulders. Some people with gallstones can develop complications, such as inflammation of the gallbladder (cholecystitis). Symptoms may include:
- Fever and shivering
- Persistent pain
- Nausea and vomiting
- Jaundice
Why is the gallbladder removed?
The gallbladder isn’t essential for digestion. If the gallbladder is removed the liver will still produce bile but it will go directly into the small intestine. Most people will not experience digestive problems. As the gallbladder is not a vital organ, it may be best to remove it if there are repeated bouts of pain or infection.
What to expect during the Gallbladder removal procedure
Gallbladder removal may be done as an elective (planned) procedure, or if the symptoms are severe, as emergency surgery.
The two techniques used to remove the gallbladder are keyhole (laparoscopic) surgery and open surgery. Depending on the situation the doctor will recommend the best approach but keyhole surgery is the most common. Both types of surgery are done in a hospital under a general anaestetic. People who have keyhole surgery generally have a shorter hospital stay compared to open surgery.
During keyhole surgery the surgeon makes four small incisions in the abdomen. A small tube with a video camera is inserted into the abdomen through one of the incisions. The surgeon watches a video monitor while using surgical tools inserted through the other incisions. Imaging such as an X-ray or ultrasound may be used. The incisions are sutured.
During open surgery the surgeon makes one large (15 centimetre) incision in the abdomen below the ribs on the right side. Muscle and tissue is pulled back to reveal the gallbladder. Once the gallbladder is removed the incision is sutured. Both types of operation take 1-2 hours.
Risks
A cholecystectomy carries a small risk of complications including:
- wound infection
- urinary tract infection
- injury to nearby structures such as the bile duct, small intestine and liver
- a gallstone left behind in the bile duct
After surgery, a small number of people may have a combination of symptoms called post cholecystectomy syndrome. This may include:
- diarrhoea
- gastritis
- inflammation of the oesophagus
- abdominal pain
Prognosis
Returning to normal activities depends on which procedure the surgeon uses and your overall health.
Most people who have their gallbladder removed find that it completely resolves their symptoms. As bile enters the intestine constantly, but in small doses, it may be difficult to digest fatty foods. Diet modification may be necessary.