Gallbladder Removal Is Common But Is It Necessary
- Hopkins study: are we removing too many gallbladders? –
- Personalized medicine might one day cut down on gallbladder surgery –
- Biggest-ever US study of gallbladder surgeries surprises JH researcher –
Johns Hopkins researchers say that the findings they published in the current edition of The American Journal of Gastroenterology could have important implications for the field of personalized medicine.
The study determined that while most patients who were hospitalized with acute biliary pancreatitis had their gallbladders removed, many patients who did not fared well over a four-year follow-up period.
Cholecystectomy, or surgical gallbladder removal, is the standard medical treatment for patients hospitalized for acute biliary pancreatitis, which typically is a result of gallstones. Because the risk of organ failure, 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.
These findings tell us that there may be a way to avoid gallbladder removal surgery, saysSusan Hutfless, Ph.D., assistant professor of medicine at the Johns Hopkins University School of Medicine and principal investigator of the study.
Is Laparoscopic Gallbladder Removal For You
Laparoscopic gallbladder removal might be the right choice for you because it is the most common type of gallbladder surgery. It might not be an option if:
- You have severe gallbladder problems, or
- You had earlier surgery in your upper abdomen.
Ask your family doctor or other health care provider if this surgery is right for you. You should also talk with a surgeon who is trained and qualified to do laparoscopic gallbladder surgery. They can help you decide.
What Are The Advantages Of Laparoscopic Gallbladder Surgery
- Smaller incision Several small incisions, each less than one inch long, instead of a 5- to 7-inch incision for open surgery.
- Less pain than after open surgery.
- Quicker recovery than open surgery You might go home the same day you have your surgery. You can also go back to regular activities more quickly.
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Is Gallbladder Removal Surgery Really Necessary
Approximately 800,000 people in America have their gallbladders removed every year. Is it necessary? Certainly, not that often. Sometimes it is absolutely necessary, but not always. How do you know for sure? Thats not easy to determine.
Most doctors advise gallbladder removal with any diagnosis of a gallbladder problem large gallstones, small gallstones, low-functioning gallbladder, few symptoms, or no symptoms.
If the diagnosis warrants surgery, you are advised to take it out. But the same diagnosis in thousands of people does not mean the same condition exists.
For example, gallstones can be silent which means you are unaware of any problem going on. There are no symptoms at all and the gallstones are found by routine lab tests done for a separate issue. You may eventually develop symptoms or you could live a long life and never experience any symptoms of gallstones.
Or you may be one of those people who have frequent attacks and ongoing gallbladder pain who just cant live with it. The majority of people we hear from here at GallbladderAttack.com are in the middle. Theyve had an attack its behind them now, but they still have discomfort that gets worse when they are under stress or when they eat the wrong foods. If you are in that camp, you have a choice to make. Part of that choice involves whether or not you are willing to make both lifestyle and dietary changes.
Why Does My Doctor Want To Remove My Gallbladder
There are several reasons why a physician may consider suggesting gallbladder removal as the best treatment. If a patient is having gallstones regularly, chronic gallbladder inflammation may affect a patients way of life and a cholecystectomy would be recommended. 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.
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What Happens During Laparoscopic Cholecystectomy
During a laparoscopic cholecystectomy, your surgeon:
- Makes a small incision near your belly button and two to three incisions in the top right part of your abdomen.
- Inserts a small tube with carbon dioxide to inflate your abdomen. This inflation offers easier access to your gallbladder.
- Uses a laparoscope to project an image of the inside of your abdomen onto a large screen.
- Removes your gallbladder by inserting small surgical tools through the incisions.
- Releases the gas from your abdomen and closes the incisions with stitches.
The Two Types Of Gallbladder Surgery
There are two different types of surgical procedures for removing a gallbladder. Both take place under general anesthesia. This, of course, means that you will be sleeping and the whole procedure will be painless.
It is important to discuss which of the two options is best for you with your doctor.
Laparoscopic cholecystectomy, sometimes also called keyhole cholecystectomy. This is the preferred option for most people, provided that there are no complicating factors. The surgeon makes a couple of tiny incisions in your abdomen. Next, he or she inserts a thin, lighted tube through one of the holes. This enables them to see inside your abdomen.
The next step is to insert one or more medical instruments such as a small camera through the other cuts. That is followed by pumping gas into your abdomen to make it bigger. The purpose of this is much more benign than it sounds: it simply gives the surgeon more space to see and work.
Using the laparoscope and one or more of the other instruments, the surgeon then removes the gallbladder. Afterward, he or she will close the incisions with surgical tape, staples, glue, or small stitches. These will automatically disappear during the healing process, so theres no need to have them removed later.
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Recovery From Laparoscopic Surgery
After a laparoscopic procedure, most people can leave the hospital on the same day as the surgery. However, a friend or family member will need to drive the individual home after surgery or accompany them in a taxi.
It is also important to rest and avoid strenuous activities for up to 2 weeks, but a person should be able to return to normal activities after this time.
Complications Of Gallbladder Surgery
Complications can be chronologically divided in two categories: early and delayed. Early postoperative complications include bleeding, bowel injury, surgical site infections and bile leak. Keep in mind that even if you are undergoing laparoscopic surgery, occasionally during the operation transition to open surgery may be necessary and you might end up with a bigger scar. The delayed complications might be postoperative chronic diarrhea, hernias at the incision site and postcholecystectomy syndrome, which includes pain and onset of new gastrointestinal symptoms after surgery.
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Gallbladders May Be Removed Too Often
5 Min Read
– Many patients with gallstones and abdominal pain dont feel better after a procedure to remove their gallbladder, and a recent study suggests this surgery may not always be necessary.
Treatment guidelines in many countries recommend that doctors perform a minimally invasive operation known as a laparoscopic cholecystectomy to remove the gallbladder when patients have abdominal pain associated with gallstones. But in non-emergency cases, theres no consensus on how doctors should choose which patients might be better off with nonsurgical treatments and lifestyle changes.
For the current study, researchers tested whether patients with gallbladder conditions being treated at outpatient clinics might have better outcomes and less post-operative pain if surgeons adopted a strict set of criteria for operating instead of the usual care practice of operating at surgeons discretion.
Researchers randomly assigned 537 patients with gallstones and abdominal pain to receive usual care, and 530 patients to get surgery only if they met five criteria: severe pain attacks pain lasting at least 15 to 30 minutes pain radiating to the back pain in the upper abdomen or the right upper quadrant of the abdomen and pain that responds to pain relief medication.
Pain relief was no better or worse with the restrictive criteria than it was with usual care. With both approaches, at least 40 percent of patients still had abdominal pain 12 months later.
Consequences Of Waiting To Treat Gallbladder Problems
Jul 7, 2015 | Gallbladder
Gallstones are stones formed in the gallbladder or bile duct and can range in size as small as a grain of sand or as large as a golf ball. When a gallstone leaves your gallbladder and blocks the passageway from your gallbladder to your intestine, it causes severe pain in the upper right part of your belly. You may vomit or feel nauseous. The pain starts suddenly and may last for several hours. This is known as a gallbladder attack.
If you have experienced signs and symptoms of a gallbladder attack you understand just how painful that can be. Once you have a gallbladder attack, your chance for having another one is high. Fortunately, there are steps you can take to reduce the likelihood of a future attack.
If your symptoms and gallbladder attacks persist, it may be time to discuss more advanced surgical treatment options. With the minimally invasive, safe surgical treatment options today, there is no need to wait and continue to suffer!
Gallbladder problems left untreated can turn into medical issues including inflammation or infection of the gallbladder, bile duct or pancreas. If the gallstones become lodged and block a duct, you can become jaundice. These complications can possibly lead to a serious medical emergency and may require surgical removal of the gallbladder. Take a proactive approach to your healthcare and identify your surgical treatment options before it becomes an emergency.
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What Is Laparoscopic Gallbladder Removal Surgery
What is the gallbladder?
Your gallbladder is a small organ in your upper abdomen. The abdomen is the area in the middle of your body that holds many organs, including the stomach and gallbladder.
What does the gallbladder do?
The gallbladder collects and stores a liquid called bile that helps your body break down food. Small, hard deposits called gallstones can form in the gallbladder. This is a common condition. If your gallstones cause health problems, doctors might do surgery to remove it. For example, you might need surgery if your gallbladder is no longer working correctly and you have pain. Your doctor will talk with you about this.
In the past, doctors made a large cut in the belly to remove the gallbladder. This is called open surgery. Today, doctors can do this surgery with tiny instruments and just a few small cuts. This is called laparoscopic surgery, because the main instrument is called a laparoscope . Minimally invasive surgery is a general term for surgery with these small instruments.
What To Expect On The Day Of Surgery
What happens during your surgery depends on the approach the surgeon uses. Regardless of the approach used, the procedure should take about one to two hours.
To give you a sense of what’s involved, here is a brief walk-through of how laparoscopic gallbladder surgery is done:
- Vital signs are taken, an IV catheter and a urinary catheter are placed, and anesthesia medication is delivered to put you to sleep. The skin of your abdomen is prepared with an antibacterial solution.
- The surgeon will begin by making four small incisions, approximately half an inch long, in the upper-right side of the abdomentwo for access for surgical instruments, one to allow the laparoscope to be inserted, and one for a port that releases carbon dioxide gas to inflating the abdomen.
- The surgeon will then separate the gallbladder from the healthy tissue and place it in a sterile bag to allow it to pass through one of the small incisions. A drain may be placed in the abdomen to prevent fluid from collecting.
- The surgeon will then inspect the area where the gallbladder was removed and close the ducts that were connected to it.
- If there are no signs of leaking, the port will be removed. The remaining gas will leak out of the incisions as the instruments are taken out.
- The incisions will then be closed with stitches or surgical staples. A sterile bandage or adhesive strips will be placed over them.
- Anesthesia will be stopped and you will be taken to a recovery area.
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When Is Gallbladder Surgery Necessary
Gallbladder surgery is an invasive surgical procedure that involves the removal of your gall bladder. Typically, gallbladder surgery is reserved for patients with severe gallstones or with extremely dysfunctional gallbladders. Frequently, gallstones are formed due to inflammation of the gall bladder. Treating this inflammation can prevent future gallstone formation that may necessitate a more invasive surgery down the road.
If you have already had one episode of gall bladder inflammation and have experienced complications from chronic cholecystitis, you will require a laparoscopic cholecystectomy. They are also known as gall bladder removal surgery. In other cases, gallbladder surgery is necessary if there has been a tornado or rupture of the gall bladder, which could spill bile into the abdominal cavity and cause serious infection.
Why And When Is Gallbladder Removal Necessary
Your gallbladder is a small sac that stores a digestive fluid called bile. Everyone is born with a gallbladder, but its not an essential organ. And unfortunately for some people, it can be a source of significant pain.
Up to 1 million Americans are diagnosed with gallstones each year, and surgeons in the United States perform about 700,000 gallbladder removal procedures annually. But is gallbladder removal necessary? And how do you know if you need your gallbladder removed?
Elvira Klause, MD, FACS, and our team can help. Dr. Klause is a minimally invasive surgeon specializing in gallbladder removal. Read on to learn the signs of gallstones and when to consider gallbladder surgery.
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What Is Gallbladder Surgery
While the surgery can be scheduled in advance, in cases of severe inflammation, gallbladder surgery is performed emergently.
How Do Doctors Find Gallbladder Problems
Your doctor will probably order a test called an ultrasound. It shows the inside of the body using sound waves. You are awake during the test, and it does not hurt.
If you need more tests, you might have a CT scan or a test called a HIDA scan. The HIDA scan uses an injection of dye to show how well your gallbladder and bile duct are working.
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Common Bile Duct Stones Or Choledocholithiasis
Gallstones develop in the common bile duct is called Choledocholithiasis. Bile flow from the gallbladder passes through the small pipes, gathered in the common bile duct, and then enters the small intestine.
In many cases, common bile duct stones are developed in the gallbladder and then moved into the bile duct which is known as secondary common bile duct stone or secondary stone. Whereas, stones that develop in the common bile duct are known as primary common bile duct stones, or primary stones. This is a very uncommon stone and leads to develop infection and prone to cause infection as compared to secondary stone.
What Are The Gallbladder Problem Symptoms
Following are the gallbladder problem symptoms:
- Pain: It generally happens in the upper right section of the abdomen that can be mild and intermittent, or it can be severe and frequent. In few cases, it can start to emanate to different body parts such as the chest and back.
- Nausea or vomiting: These are the most common symptoms in patients. Under chronic gallbladder problems might leads to digestive problems, for example, excessive gas and acid reflux.
- Unusual stools or urine: Stools lighter in color and dark urine are common signs of blockage in the bile duct.
- Chronic diarrhea
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Emergency Gallbladder Surgery: Do You Need It Or Can You Afford To Wait
Study: younger, older people likelier to visit ER repeatedly with gallstone pain before surgery
ROCHESTER, Minn. Gallstone pain is one of the most common reasons patients visit emergency rooms. Figuring out who needs emergency gallbladder removal and who can go home and schedule surgery at their convenience is sometimes a tricky question, and it isnt always answered correctly. A new Mayo Clinic study found that 1 in 5 patients who went to the emergency room with gallbladder pain and were sent home to schedule surgery returned to the ER within 30 days needing emergency gallbladder removal. The surgical complication rate rises with the time lag before surgery, the researchers say.
It makes a big difference if you get the right treatment at the right time, says co-lead author , a gastroenterologic surgeon at Mayo Clinic in Rochester. The study is published in the Journal of Surgical Research.
Often its obvious who needs emergency gallbladder removal, a procedure known as cholecystectomy, who can delay it and who doesnt need surgery at all. But sometimes patients fall into a gray area. Mayo researchers are working to develop a reliable tool to help determine the best course of action in those cases, and the newly published study is a first step, Dr. Bingener-Casey says.
When To Consider Gallbladder Removal Surgery
People who dont have gallstones or who dont have symptoms dont need gallbladder surgery. But if you have gallstone symptoms, schedule a consultation with Dr. Klause.
She specializes in diagnosing and treating gallstones and can help you decide if gallbladder surgery is right for you.
Most of the time, gallstones can be diagnosed with an abdominal ultrasound. If we find gallstones and you have a history of gallstone pain and other symptoms, we may recommend gallbladder removal to treat the condition.
Dr. Klause performs laparoscopic cholecystectomy, which is a minimally invasive procedure that uses very small incisions. After gallbladder removal, you should notice that your gallstone symptoms go away. Full recovery takes about six weeks, and most people dont notice any lasting effects after the procedure.
Are you bothered by gallstone pain? Gallbladder removal may be the best treatment for you. Contact us online or call our San Clemente, California, office at 949-393-2595 for a consultation.
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