Gallbladder Surgery & Removal Specialist in Sydney
Where is my gallbladder?
Your gallbladder is found in the right, upper part of your abdomen. It is a pear-shaped sack that is attached to the underside of your liver.
What does my gallbladder do?
Your gallbladder stores about half of the bile that is produced by your liver. Bile is a greenish-brown liquid, used by your digestive system to help break down fatty food.
Do I need my gallbladder?
No. The best way to treat symptoms related to your gallbladder is to have it surgically removed.
What are gallstones, and who gets them?
Gallstones are hard deposits that can be formed from the substances that make up bile. Most gallbladder problems are caused by gallstones.
Anyone can get gallstones, but they are most common in women over the age of 40, particularly those who have had children or are overweight. There is no proven way to prevent gallstones.
What kind of problems can gallstones cause?
A person can have gallstones and not be aware of them. However, if a gallstone temporarily blocks the cystic duct (the tube coming from out of the gallbladder), this can cause severe pain and nausea. Pain due to gallstones is usually felt in the right upper abdomen, and may spread towards the back, or the right shoulder. It can also occur behind the chest bone resembling heart pain. This is known as biliary colic, and it can be a recurring problem. Some patients notice that it tends to occur after a heavy, fatty meal.
When gallstones cause inflammation of the gallbladder, this is known as acute cholecystitis. A person with acute cholecystitis can become very ill, with severe pain, vomiting and fever. If untreated, acute cholecystitis can occasionally lead to life-threatening complications.
Another serious complication of gallstones is acute cholangitis. This occurs when gallstones block the bile duct (the main tube that takes bile from the liver and gall bladder, to the small intestine). Acute cholangitis can cause similar symptoms to cholecystitis, but can also cause jaundice (yellowing of the skin and eyes), dark urine and pale stools.
If a gallstone blocks the pancreatic duct (the tube through which the pancreas releases digestive enzymes into the small intestine), this can irritate the pancreas and lead to gallstone pancreatitis. Apart from causing severe pain, this condition can be life-threatening.
How is a gallbladder problem diagnosed?
It is important that an abdominal ultrasound or a CT scan is used to confirm the diagnosis of gallstones, as there are other conditions which may cause similar symptoms. Other specialised tests that enable the specialist to see the bile ducts more clearly, include a CT-cholangiogram and MRCP. A CT-cholangiogram is a CT scan with the injection of contrast (“dye”) into a vein. An MRCP is an MRI scan that uses intravenous contrast in a similar way. At Sydney Surgical Clinic, we make use of the best imaging modalities available, to ensure a safe surgery and an optimal recovery.
How are gallbladder problems treated?
The best way to treat symptoms related to gallstones, is to have your gallbladder removed. In the vast majority of cases (98 – 99%), this is done via a laparoscopic cholecystectomy. With laparoscopic, or “keyhole” surgery, the surgeon makes 3 or 4 small incisions. The abdomen is filled with gas, to give the surgeon space to work, and a small camera is inserted through one of the openings. The inside of the abdomen can be seen on a television screen in the operating theatre, and the surgeon works with narrow instruments through the tiny incisions.
The advantages of laparoscopic surgery are:
- Less pain after the operation
- Faster recovery
- Smaller surgical scars
In rare cases, however, it may be necessary to remove the gallbladder via open surgery.
For example, in an unwell patient with acute cholecystitis, it may not be possible to perform a laparoscopic cholecystectomy safely. If this is the case, open surgery is done, and only part of the gallbladder removed. This is called an open partial cholecystectomy. The recovery takes longer and may require an additional endoscopic procedure called ERCP.
A procedure which is sometimes done before or after gallbladder surgery, is ERCP (endoscopic retrograde cholangio-pancreatography). An ERCP is similar to a gastroscopy. From your mouth, a small flexible tube is put down your throat to your stomach, and then to the first part of your intestine. From here, your specialist injects contrast (“dye”) that helps him/her to see the pancreatic and bile ducts on X-ray. ERCP can be used to diagnose a problem, and also to remove gallstones that are blocking the ducts. However, the procedure does not remove gallstones in the gallbladder, and a cholecystectomy may be required at a later stage.
Another procedure, which is occasionally done in more complicated cases, is a percutaneous cholecystostomy. With this procedure, an ultrasound machine guides a specialist in placing a needle through the skin, with a tube to drain bile from the gallbladder. This procedure may be used in very ill patients while they are awaiting surgery.
For laparoscopic or open gallbladder surgery, you will receive general anaesthesia (be asleep during the procedure). An ERCP is usually done with sedation (medication that makes you feel drowsy) but can be done under general anaesthesia in some cases.
How long will I take to recover from gallbladder surgery?
A laparoscopic cholecystectomy often requires an overnight stay. Occasionally, in a younger group of patients it can be done as a day procedure. After surgery, you will experience some pain at the incision sites. It is also possible to experience some shoulder tip pain for a couple of days following the surgery. You will be sent home with pain medication, which should relieve these symptoms. It is important to follow the discharge instructions that you receive from the hospital, and to attend your specialist follow-up appointment.
For uncomplicated laparoscopic surgery, recovery usually takes around 2 weeks, although you may feel fatigue for a month or so. For open surgery, or in more complicated cases, recovery may take up to 6 weeks. At Sydney Surgical Clinic, we are committed to helping you with every step of the healing process.
