Why remove gallbladder

According to the Mayo Clinic , laparoscopic cholecystectomy is the most common type of gallbladder removal surgery performed. However, open gallbladder surgeries are still used for a variety of people, especially those who have scar tissue or other anatomical complications from prior abdominal surgeries.

Bile can be thick and create blockages along the pathway where it typically empties. The gallbladder is also prone to develop gallstones in certain people.

Gallstones are hard deposits of substances in the bile that can get stuck inside the gallbladder and biliary ducts. They can be as small as a grain of sand or as large as a golf ball.

Gallstones can also lead to acute or chronic gallbladder inflammation, sometimes with an associated infection, which can cause:. A surgeon will remove your gallbladder if gallstones cause significant pain and other complications.

A doctor will recommend gallbladder removal if your gallbladder is causing a severe, acute problem or has become a chronic concern. Some symptoms that may indicate the need for gallbladder removal include:. Sometimes a doctor will recommend watchful waiting to see if gallbladder-related symptoms lessen. Diet changes, such as reducing overall fat intake, may also help. If symptoms persist, a doctor may recommend surgery. Open gallbladder removal is considered a safe operation.

Complications are rare. However, every surgical procedure carries some risks. Before the procedure, your doctor will perform a complete physical examination and medical history to minimize these risks. Your surgeon will explain these risks to you and give you the chance to ask questions prior to the procedure. These will include blood tests and imaging tests of your gallbladder.

You may need to have additional imaging studies, such as a chest X-ray or an EKG , depending on your medical history. A complete physical exam and record of your medical history will also be needed. Certain medications can interfere with the procedure.

You may have to stop taking them prior to surgery. Whenever possible, laparoscopic surgery is preferred over traditional open surgery. However, certain complications can make open surgery a better choice, such as when the gallbladder is severely diseased.

A severely diseased gallbladder can be more difficult to remove because it may have affected surrounding areas, which makes a laparoscopic procedure more difficult. If someone has had prior abdominal surgeries that caused inflammatory changes near the gallbladder area, such as scar tissue adhesions, this may also make a laparoscopic cholecystectomy less possible.

According to the American College of Surgeons ACS , a surgeon starts with a laparoscopic method and converts to an open method if needed. The likelihood of an open method is:.

An intravenous IV line will be inserted into a vein in your arm or hand for the purpose of anesthesia. Your abdomen will first be cleansed with an antiseptic solution to reduce infection risk. Your surgeon will then make an incision in your abdomen. There are several reasons why a physician may consider suggesting gallbladder removal as the best treatment. This procedure is often used when there are stones in the gallbladder which are causing symptoms such as vomiting, pain, and sometimes even back pain and bloating.

The three most common symptoms of an inflamed gallbladder are bloating, nausea, and vomiting. If these symptoms occur regularly, gallbladder removal may relieve pain. While gallbladder stones are the most common cause for a recommendation of surgery, three other leading conditions are common reasons why a physician will suggest surgery.

This disease often occurs when the gallbladder will not empty bile correctly due to a hindrance in motion. This often causes a lot of pain for the patient. Pancreatitis is a considerably more serious situation. This is the inflammation of the pancreas and can lead to vomiting and bloody stools. This condition is caused when gallbladder stones have moved to the bile duct but may be stuck. Because the risk of organ failure, sepsis and other dangerous complications increases with recurrent attacks of biliary pancreatitis, the procedure is recommended within four weeks of the initial diagnosis.

But what about patients with that condition who, for whatever reason, do not have their gallbladders removed? Seventy percent of the patients in the study who declined the surgery were not hospitalized again for pancreatitis. The study was designed as the largest-ever look at adherence to the accepted medical guidelines around pancreatitis hospitalizations.

The finding about patients who do not adhere was incidental. Patients in the study had private insurance and were under the age of Seventy-eight percent of those patients had their gallbladders removed within 30 days of their initial hospitalization, in keeping with accepted medical guidelines. Less than 10 percent of those patients returned to the hospital with pancreatitis.

Of the 3, patients who did not adhere to the guidelines, 1, had a cholecystectomy within six months. But the nearly 2, patients who did not have the surgery within 30 days had still not had it four years later. Numerous studies have found that, in most cases, cholecystectomy prevents additional pancreatitis-related hospitalizations.

The authors list a number of barriers that could prevent people suffering from the condition to comply with physician recommendations of gallbladder removal. Lack of resources, surgeon or patient preference , and inaccurate billing coding each could be a reason why a patient with biliary pancreatitis would not undergo cholecystectomy.

But with nearly 80 percent of those patients undergoing the procedure, Kamal says the compliance numbers were unexpectedly high. It is not clear why some noncompliant patients had recurrences and some did not.