What is a gallbladder?
The gallbladder is a small pear shaped organ that sits next to the liver in the right upper abdomen. It’s function is to store and release bile. Bile is made by the liver and is used to break down fats in the food we eat as part of digestion. In addition to bile, about 25% of people will have gallstones and/or sludge (thick bile) within the gallbladder. Gallstones can range in size from 2mm to several inches. People can have one stone or they could have greater than 50 stones in the gallbladder! The gallbladder is connected to a ductal system which delivers the bile to the intestines. If stones are present, they can block or clog the ducts leading to pain and/ or infection. However, most people with stones in their gallbladder do not develop any symptoms.
What are symptoms of gallbladder disease?
Abdominal pain is the most common symptom of gallbladder disease. The pain is usually on the right side of the upper abdomen, near the ribs, and may also be felt in the back, near the right shoulder or shoulder blade. The pain usually begins within 30-60 minutes of eating a fatty or greasy meal. The pain may or may not resolve on it’s own. Other symptoms may include some or all of the following:
Gas / Bloating
Jaundice (yellowing of the skin and eyes)
Testing to find out if there is a problem with the gallbladder
To determine if the gallbladder might be the cause of upper right quadrant pain, we typically prescribe laboratory blood tests that examine liver function and other parameters that might indicate an infection. We also depend heavily on ultrasound scans of the area to look at the gallbladder and liver to see if there are any stones present or any other signs of inflammation. Doctors may recommend additional testing including MRI and endoscopy if needed.
What are other problems that can occur with the gallbladder?
Sometimes other problems can result from stones blocking the main bile duct or the pancreas leading to jaundice and pancreatitis (inflammation of the pancreas). This may require additional testing and/or procedures prior to cholecystectomy.
Some people may have problems with the gallbladder even without having stones or sludge present. Sometimes individuals may have a delay in gallbladder emptying which can also cause symptoms similar to those of gallstones. This is called biliary dyskinesia and is usually diagnosed with a separate test called a HIDA Scan, or CCK-HIDA scan.
Some people may have a polyp or small growth in their gallbladder, which typically does not lead to symptoms; however, depending on size it may be recommended to be removed. In addition, any concerning mass in the gallbladder should also be removed and evaluated by a surgeon.
Cancer of the gallbladder is a very rare disease.
What is the treatment of gallbladder disease ?
If there is suspicion for gallbladder disease sometimes symptoms can be managed with dietary changes, such as avoiding fatty meals. In general, we recommend less than 40 grams of fat per day and avoiding fatty foods such as butter, oils, avocados, nuts, dairy, cheese and fried food. If the pain persists despite these changes in diet, one should see a surgeon in order to assess if the removal of the gallbladder, a procedure called cholecystectomy, might be needed. Some patients may develop pain that does not resolve after a few hours or is accompanied with fevers, vomiting and jaundice (yellowing of the skin and eyes) if this occurs we recommend notifying your physician and/or possible emergency room evaluation.
A cholecystectomy is a very common and safe surgical procedure. It is done in a hospital while you are asleep under general anesthesia. The operation is typically performed by the laparoscopic method, with 4 small 1/2 inch incisions. Patients usually go home on the same day as their surgery.
As in all operations, there are risk for infection, bleeding, and injury to surrounding structures such as the nearby biliary tree. Rarely, the surgery cannot be completed by the laparoscopic method, and the surgery has to be converted to an open surgery. This happens about 1-2% of all cholecystectomies. Your surgeon will speak to you of these possibilities during your consultation. Also, your surgeon will need to verify that you are a candidate for safe surgery by checking with your medical doctor(s).
Recovery from laparoscopic cholecystectomy is done at home. Most people are able to return to work and drive after 4-5 days, although we encourage no heavy lifting for 4 weeks. We will give some pain medication if needed but most patients do not need to take any form of narcotics and typically are able to manage their pain with tylenol or ibuprofen.
How can we help take care of your gallbladder disease at Atlantic Surgical Group?
Our practice has had over 30 years of experience in successfully providing excellent care for patients with gallbladder disease. We pride ourselves on our commitment to safe gallbladder surgery and providing patients the best outcomes possible. We have extensive experience providing minimally invasive gallbladder surgery, including having the honor of being part of the first ever laparoscopic cholecystectomy team in the Monmouth County. We have a team of surgeons that have high level training in managing both straightforward and complex gallbladder disease. We work very closely with gastroenterologist and primary doctors in order to provide the best care.
If you would like to be evaluated for gallbladder disease, please notify our office and we would be more than happy to see you and to be part of your care team. Call for an appointment at 732-531-5445.