Gallbladder Removal

The gallbladder is a small pear shaped pouch-like organ in the upper right hand side of the abdomen, sitting just under the liver. The gallbladder stores bile, a fluid produced by the liver that helps break down fatty foods. A gallbladder is not essential to the human body so is often recommended for removal if you develop any problems with it.

Causes of Gallstones

Gallstones or ‘stones’ develop in the gallbladder or bile ducts when bile, which is normally a fluid-like consistency forms into stones. Gallstones usually contain lumps of fatty material (cholesterol-like) that solidifies and hardens. Calcium deposits and bile pigments (usually black or brown) can form gallstones. The size of stones can vary in size, with sometimes lots of small ones developing, or just one large one.

Gallstones are more common in women, with 1 in 3 developing them, compared to 1 in 6 men. Typical causes include:

• Pregnancy
• Rapid weight loss
• Obesity
• Excessive alcohol consumption
• Diabetes
• A family history of gallstones
• Increasing age
• Certain medications, including the contraceptive pill

Reducing your alcohol intake and eating a vegetarian diet can help reduce your risk of developing gallstones.

Symptoms of Gallstones

The majority of people who have develop gallstones do not realise they have them as most do not cause any symptoms. However, you may start to have intermittent pain felt in the upper right abdomen known as biliary colic. Pain does not usually last for longer than a few hours and can be reduced by cutting out foods that are high in fat from your diet, particularly fried foods.  Other symptoms may include:

• Nausea
• Vomiting
• Excessive burping
• Indigestion
• Dark urine
• Clay coloured stools
• Diarrhoea

Risks and Complications from Gallstones

In certain cases, complications can arise from gallstones which include:

Acute Cholecystitis

Acute cholecystitis occurs when a gallstone blocks the duct where bile moves from the gallbladder, causing inflammation and infection in the gallbladder. This is a serious medical condition and will need emergency treatment. The risk of developing acute cholecystitis is low with usually between 1-3% of people experiencing symptoms. These can include:

• Fever and chills
• Severe abdominal pain
• Loss of appetite
• Pain in the mid-right back
• Nausea and vomiting

If symptoms last for longer than 1-2 hours, call your doctor or NHS 111 immediately.

Jaundice

Jaundice, which is a term used to describe the yellowing of your skin and eyes can indicate you have gallstones. If you notice a change in colour, it is important that you see your doctor immediately in order to diagnose the cause of your jaundice.

Pancreatitis or Inflammation of the Pancreas

Pancreatitis simply means inflammation of the pancreas with the most common causes being gallstones and excessive use of alcohol. There are 2 types of pancreatitis – acute and chronic. Typical symptoms of pancreatitis include:

• Nausea and vomiting
• Abdominal pain that radiates to the back
• Lethargy and weakness
• Tenderness of the abdomen to touch
• Chills and fever
• Pain that worsens after eating

Gallbladder Cancer

With symptoms closely resembling those of gallstones, this rare form of cancer can be difficult to diagnose. In the early stages, gallbladder cancer does not cause any symptoms which usually means it is not diagnosed until it is at a more advanced stage.  Symptoms of gallbladder cancer can include:

• Abdominal pain
• Nausea and vomiting
• Jaundice
• Unexplained weight loss
• Loss of appetite
• Itchy skin

These symptoms may not be related to gallbladder cancer as a number of conditions can cause them, but it is recommended that you speak to your doctor if you are experiencing anything unusual.

Diagnosis of Gallstones

If you think you may have gallstones, speak to your doctor who will be able to carry out a series of tests to reach an accurate diagnosis. Typical tests include the following:

Abdominal Ultrasound

This is the most common method used when looking for signs of gallstones. A small device called an ultrasound probe is placed on the abdomen which gives off high-frequency sound waves. You cannot hear them, but when they bounce off different parts of the body, they create what are called ‘echoes’ and turned into a moving image. You will be able to see the images displayed on a monitor whilst the scan is being carried out.

Endoscopic Ultrasound Scan (EUS)

An endoscopic ultrasound scan uses an endoscope with an ultrasound probe attached to create detailed pictures of internal organs and structures. It is typically used to discover smaller stones which may have been missed by an abdominal ultrasound.

Similar to an abdominal ultrasound, the probe will send back signals which make a picture of the parts of the body surrounding the probe. The clinician may take one or more small biopsy samples which is painless, after which the endoscope is removed. Samples are then sent to the laboratory for testing.

Imaging

Imaging tests are often carried out, usually by CT scans, MRCP or ERCP.

Treatment of Gallstones

You will be required to attend a pre-assessment appointment in the weeks leading up to your gallbladder removal surgery. During this appointment, you may have your bloods taken to check you are fit for surgery and decide which surgical option is best for you. Blood tests can also rule out infection and pancreatitis. You will be informed about how to reduce the risk of complications after surgery such as lifestyle changes. Make sure you ask any questions you may have regarding your surgery to ensure you feel comfortable with the procedure and the information provided to you.

Gallbladder removal surgery (cholecystectomy) is a very common procedure with two main ways of removal – laparoscopic (keyhole) surgery or open surgery. Both procedures are performed under general anaesthetic meaning you will be asleep throughout the surgery and will not feel any pain.

Keyhole surgery is most commonly performed as recovery time is quicker, meaning you will not have to spend as long in hospital following surgery. You can generally go home the same day following your procedure, with recovery taking around 2 weeks.  As the incisions made with keyhole surgery are much smaller compared to open surgery, scarring will be minimal.

Open surgery may be recommended if you are unable to have keyhole surgery due to a mass of scar tissue on our stomach from previous procedures. You will usually have to stay in hospital for a few days after the surgery with recovery typically taking 6-8 weeks.

Occasionally your surgeon may need to change from a keyhole procedure to open surgery during the operation. This will be explained to you prior to your procedure.
The length of time the surgery takes can vary; planned keyhole surgery may take around one hour, depending on how swollen the gallbladder is and whether there are any further complications.

Recovery from Gallbladder Removal Surgery

Following keyhole surgery as a day procedure, you will generally be required to spend a few hours recovering, after which you can go home when you feel ready to. You will need to arrange for someone to drive you home. Try to ensure you have someone with you for the first 24 hours after your surgery as you may feel a little tired or emotional after your operation. You may also find that you struggle to think clearly; this should pass within a day or so, after which you should be able to return to normal activities, usually around 2 weeks after the surgery.

If you had open gallbladder removal surgery, you will usually have to stay in hospital for 3-5 nights, again making sure someone is available to take you home after you have been discharged. Recovery time is generally longer compared to keyhole surgery, typically taking between 6-8 weeks to return to normal activities following the procedure.
Maintaining a healthy lifestyle, stopping smoking and resting when needed will help your recovery process. If you find that you require pain relief, you can take over-the-counter medication such as ibuprofen and paracetamol (always read the patient information).

Returning to work after keyhole surgery can take anything from 10-14 days. It differs depending on the recovery process and the type of job you do. After open surgery, it will take longer to get back to work. Speak to your doctor for advice.

Complications from Gallbladder Removal Surgery

Most people do not experience any complications following gallbladder removal surgery. However, as with any surgery, complications can occur, which can include:

• Infection
• Excessive bleeding
• Blood clots
• Adverse reaction to the anaesthetic

Potential complications specific to gallbladder removal surgery include:

• Injury to the bile duct
• Injury to surrounding organs, including the bowel
• Post-cholecystectomy syndrome

Side effects are unwelcome, but generally brief symptoms you may experience post-surgery can include:

• Pain in your abdomen and shoulder resulting from the gas used during surgery. This should pass after a couple of days. Painkillers will help ease any discomfort you may be feeling.
• Diarrhoea, flatulence and vomiting which can last for a few weeks. Eating a diet rich in fibre such as wholemeal bread, brown rise and fruit and vegetables will help.
• Tiredness and mood swings are common during the recovery process but will pass.
• Swollen and/or bruised wounds can occur, but regular painkillers such as paracetamol can help ease any discomfort you are experiencing, and you should start to see improvements within a few days.

Need Help?

Gallbladder removal surgery is available at One Ashford Hospital with a leading Consultant General Surgeon. We can book you in to see a specialist surgeon, usually within 48 hours, for an initial consultation.  We are ideally placed to see patients from Ashford, Maidstone, Folkestone, Canterbury, Dover and all surrounding areas.

You can use your private medical insurance or pay for your Gallbladder Removal treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• 0% and low finance options**
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

**Terms and conditions apply

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