The gall bladder is a pear-shaped sac that is located on the right side of the abdomen, just below the liver. It stores and concentrates bile (a liquid made by the liver that helps in fat digestion). The majority of patients who have gall bladder problems are due to the formation of stones in the gall bladder that can block the opening. Some patients will develop problems with their gall bladder that are not associated with stones.
Right upper quadrant abdominal pain is most commonly associated with gall bladder problems. Fever, chills, nausea, vomiting, bloating after eating, indigestion and diarrhea are other common symptoms. Most gall bladder problems are diagnosed with an ultrasound of the abdomen. Sometimes other testing, such as blood testing, CT scan or nuclear medicine tests may diagnose the problem.
Frequently surgery is required to remove the gall bladder. Often it may be able to be removed with the use of a few tiny incisions (laparoscopic cholecystectomy). The abdomen is distended with the use of some carbon dioxide. The gall bladder is removed by cutting the duct and the artery that go to the gall bladder and peeling it off the liver where it is normally attached. It is then brought out to the belly button, where the gall bladder is then opened and the fluid removed. This is how we get it out of the tiny incision. Stitches are placed underneath the skin. The traditional surgery may be required in about 2 – 3 percent of patients, but your surgeon will talk to you about that. Bleeding, infection, injury to surrounding organs and injury to the main bile duct can occur during surgery, but these complications are not common. Stones in the main bile duct are sometimes identified and need to be removed. They can be removed with surgery or can be removed by looking into the stomach with a lighted tube and removing them for the inside (ERCP). Ten to 15% of patients may develop diarrhea after surgery. This is usually self-limited and gets better on its own in a few weeks. It is uncommon to need medicine to control the diarrhea or have diarrhea for a prolonged period of time.
Laparoscopic cholecystectomy is often done as an outpatient procedure. Patients arrive at the hospital the morning of surgery, undergo surgery which usually takes about 1 hour to complete, and go home that same day after a brief recuperation in the outpatient part of the hospital. Patients are walking around the following day and most patients return to normal activity within 2 weeks of surgery. Patients usually resume a normal diet in a few days.
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