Why do you need a gallbladder removed

A cholecystectomy (koh-luh-sis-TEK-tuh-me) is a surgical procedure to remove your gallbladder — a pear-shaped organ that sits just below your liver on the upper right side of your abdomen. Your gallbladder collects and stores bile — a digestive fluid produced in your liver.

A cholecystectomy is a common surgery, and it carries only a small risk of complications. In most cases, you can go home the same day of your cholecystectomy.

A cholecystectomy is most commonly performed by inserting a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder. Doctors call this a laparoscopic cholecystectomy.

In some cases, one large incision may be used to remove the gallbladder. This is called an open cholecystectomy.

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Why do you need a gallbladder removed
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Gallstones

Why do you need a gallbladder removed

Gallstones

Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum).

A cholecystectomy is most commonly performed to treat gallstones and the complications they cause. Your doctor may recommend a cholecystectomy if you have:

  • Gallstones in the gallbladder (cholelithiasis)
  • Gallstones in the bile duct (choledocholithiasis)
  • Gallbladder inflammation (cholecystitis)
  • Large gallbladder polyps
  • Pancreas inflammation (pancreatitis) due to gallstones

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Your gallbladder is a pear-shaped organ that stores bile, the fluid that helps digest food. If it’s not working the way it should (or your bile gets out of balance), hard fragments start to form. These can be as small as a grain of rice or as big as a golf ball.

Gallstones don’t go away on their own. If they start to hurt or cause other symptoms, your doctor may decide to remove your gallbladder. This type of surgery is called a cholecystectomy. It’s one of the most common surgeries doctors perform.

About 80% of people who have gallstones will need surgery.

Types of Gallbladder Surgery

Doctors can remove your gallbladder in one of two ways:

Open surgery: During this procedure, your surgeon will make a 5- to 7-inch incision (cut) on your belly to take out your gallbladder. You’ll need open surgery if you have a bleeding disorder. You may also need it if you have severe gallbladder disease, are very overweight, or are in your last trimester of pregnancy.

Laparoscopic cholecystectomy: Doctors also call this “keyhole surgery.” Your surgeon doesn’t make a big opening in your belly. Instead, they make four small cuts. They insert a very thin, flexible tube that contains a light and a tiny video camera into your belly. These help your surgeon see your gallbladder better. Next, they’ll insert special tools to remove the diseased organ.

For both types of surgery, you’ll be given general anesthesia. This means you’ll sleep through the procedure and won’t feel any pain while it’s being done.

Do I Need Surgery?

If your gallstones aren’t causing symptoms, there’s usually no need for you to have surgery. You’ll only need it if a stone goes into, or blocks, one of your bile ducts. This causes what doctors call a “gallbladder attack.” It’s an intense, knife-like pain in your belly that can last several hours.

If you have sickle cell or another blood disorder, your doctor may consider doing a cholecystectomyas a precaution, even it you don't have symptoms. 

If left untreated, gallstones can also lead to more serious problems, like:

  • Cholecystitis -- an inflamed gallbladder
  • Pancreatitis -- an inflamed pancreas
  • Cholangitis -- inflamed bile ducts

Before your doctor opts for surgery, they’ll run several tests to see the effect your gallstones are having on your health. Tests might include:

  • Blood test
  • Ultrasound
  • MRI HIDA (hepatobiliary iminodiacetic acid) scan -- a radioactive chemical is put into your body to create images of any blocked ducts
  • Endoscopic ultrasonography -- an imaging device is put into your mouth and down through your digestive tract so sound waves can create a detailed picture of your small intestine

Can I Try Other Treatments First?

You may be able to manage your symptoms for a short time by making changes to your diet. This includes cutting back on fatty foods. But dietary changes don’t always help prevent gallbladder attacks.

If surgery isn’t an option for you, your doctor can prescribe a medication to dissolve your gallstones. But this can take months or even years to work. And even if your gallstones do go away, there’s a chance they’ll return.

Gallbladder Surgery Risks

You can live without your gallbladder. Your liver can make enough bile on its own. This will naturally find its way into your small intestine even if your gallbladder is removed.

Doctors believe gallbladder surgery is safe, but some problems can still arise. These may include:

  • Problems with anesthesia
  • Infection
  • Bleeding
  • Swelling
  • Bile leakage
  • Damage to a bile duct
  • Damage to your intestine, bowel, or blood vessels
  • Deep vein thrombosis (blood clots)
  • Heart problems
  • Pneumonia

You also run the risk of a problem doctors call “post-cholecystectomy syndrome” (PCS). It can happen if any gallstones are left in your bile ducts or bile happens to leak into your stomach. The symptoms of PCS are similar to those of gallstones. They include belly pain, heartburn, and diarrhea.

Recovery

The length of time it takes you to heal depends on the type of surgery you have.

If you have your gallbladder removed during open surgery, you’ll need to stay in the hospital for a few days afterward. It may take between 6 to 8 weeks for your body to heal fully.

Laparoscopy is less involved, so you’ll have less pain and heal faster than if you have open surgery. Most people who have it are able to go home from the hospital the same day. You’ll likely be back to your normal routine within 2 weeks.

Show Sources

SOURCES:
University of California San Francisco Medical Center: “Gallstones.”

Society of American Gastrointestinal and Endoscopic Surgeons: “Laparoscopic Gallbladder Removal (Cholecystectomy) Patient Information from SAGES.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Dieting and Gallstones.”

Harvard Health Publications: “What to To Do About Gallstones?”

NHS Choices: “Gallstone Treatment,” “Gallbladder Removal -- Complications,” “Gallbladder Removal -- What Happens.”

Mayo Clinic: “Cholecystectomy (Gallbladder Removal),” “Endoscopic Ultrasound.”

Better Health Channel/State Government of Victoria, Australia: “Gallbladder: Gallstones and Surgery.”

When should gallbladder be removed?

Most doctors recommend surgery if you have had repeated attacks. If you have had one attack of gallstone pain, you may want to wait to see whether you have more. Surgery is the best way to prevent gallstone attacks. The surgery is very common, so doctors have a lot of experience with it.

What is the downside of having gallbladder removed?

When the gallbladder is removed, special clips are used to seal the tube that connects the gallbladder to the main bile duct. But bile fluid can occasionally leak out into the tummy (abdomen) after the gallbladder is removed. Symptoms of a bile leak include tummy pain, feeling sick, a fever and a swollen tummy.

What causes problems with your gallbladder?

Stones or thickened bile and tiny particles (sludge) can block the bile duct and lead to cholecystitis. Kinking or scarring of the bile ducts can also cause blockage. Infection. AIDS and certain viral infections can trigger gallbladder inflammation.

What are the warning signs of gallbladder?

Symptoms.
Sudden and rapidly intensifying pain in the upper right portion of your abdomen..
Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone..
Back pain between your shoulder blades..
Pain in your right shoulder..
Nausea or vomiting..