How Common is Gallbladder Surgery?
Most people have heard about gallbladder stones and have a basic understanding of the problems gallstones can cause. Other than hernias, gallbladder problems are the most common issue we see. Occasionally, gallbladder stones aren't the issue, and instead, a patient may have gallbladder dysfunction. Gallbladder dysfunction can cause extreme pain, but patients may choose to delay surgery. Although, its often suggested and common that people have surgery once the dysfunction is recognized, as the condition can worsen over time. If you are experiencing these symptoms, the best option is to have your gallbladder removed.
Take Advice from Dr. Steven Williams, General Surgeon in Boise
"I was taught in medical school, 10% of the population has gallstones, but not all of those patients are symptomatic. Therefore, you may not need an operation unless you're experiencing symptoms and pain. At this point in my career, I recommend considering gallbladder surgery since it is so minimally invasive and such a safe operation in the right hands."
A Bad Gallbladder: Three Common Scenarios
1. You have gallstones and symptoms of pain
Removing the gallbladder is most recommended as your best option if you have symptoms and stones.
2. You do not have gallstones but you have pain
This is caused by gallbladder dysfunction.
3. You have gallstones and no symptoms of pain
As stones can often become a problem in the future, if imaging reveals stones, getting your gallbladder removed by a good surgeon can be a significant preventative step.
Visit Dr. Williams' Website
The Abdominal Wall
The abdominal wall is strengthened by layers of muscle, fat, and other tissues. Hernia surgery repairs the weakness in the muscle and connective tissue. This prevents the intestines or other tissue from bulging out again.
Emergencies Caused by the Gallbladder
Dr. Steven Williams of Capital Surgical Associates has performed many emergency gallbladder surgeries for patients that have ignored the pain from their condition. Things Dr. Steve Williams has noticed from patients needing urgent gallbladder surgery:
- It's often found that patients who need urgent gallbladder surgery have known about gallstones for years but never did anything about it.
- They come in excruciating pain to the emergency room and then are admitted for gallbladder disease.
- It is always more difficult for the surgeon to perform emergency gallbladder surgery and cause more complications and overall, financially cost more.
- Each of these patients wishes they could have scheduled their surgery to their convenience, and more importantly, could have avoided the discomfort that comes with being very sick.
Despite continued improvements in critical care and medical technology, many people still die from gallstone pancreatitis each year. This condition results from a gallstone migrating down the duct and becoming an obstruction.
Where is the Gallbladder and What is its Function?
Just under your right rib cage, also referred to as the right upper quadrant of the abdomen, you will find your gallbladder. The most common site of pain from your gallbladder will be found in the right upper quadrant of the abdomen. However, you may experience gallbladder pain in the left upper quadrant of the abdomen or in the right lower quadrant. Surprisingly, gallbladder pain can also be felt in the right shoulder, in the back near the scapula, or even across the entire upper abdomen.
The liver creates bile, and the gallbladder is connected to the liver by the bile ducts. Bile helps break down fats from the foods we eat; it is a necessary step in digesting any oils or fats that we eat. The gallbladder stores and releases extra bile formed. The gallbladder is a storage organ, as bile normally flows down the bile ducts, into the intestine, and through the digestive system. Many patients have concerns about digestive problems after their gallbladder is removed, however, Dr. Williams has seen this as a rare occurrence. When the gallbladder is removed, most people don't miss this extra storage capability. In Dr. Williams experience, Within a few weeks most patient's digestive function normalizes within a few weeks, if not immediately after surgery.
The Surgical Technique Performed During a Gallbladder Removal
With extremely rare exception, all gallbladders should be removed with a laparoscopic approach. Utilizing very thin incisions in the abdomen, the standard laparoscopic approach uses for trocars, small hollow plastic or metal tubes. Trocars are placed through the abdominal wall to give access to the gallbladder. Surgeons use telescopic cameras and long tools to reach the gallbladder. About 95% of surgeons use this approach.
Boise General Surgeon, Dr. Steve Willams Unique Approach to Gallbladder Removal
Over the last 10 years, Dr. Williams has performed gallbladder surgeries with only three incisions. One less incision benefits the patients with one less scar and one less weak point on the abdominal wall. The method, using three incisions, also can reduce the chances of a hernia at the site of the fourth port.
Single Site Laparoscopic Approach
da Vinci Surgical Technology Performed by Dr. Steve Williams
In January 2013, Dr. Williams was the first to perform a single site robotic laparoscopic cholecystectomy in the State of Idaho at Saint Alphonsus in Boise. The surgery is performed through a single-site gallbladder surgery, using the da Vinic robot only a single incision is necessary. The da Vinci single-incision does require a somewhat larger incision which is usually 2.5 centimeter, or 1 inch. According to Dr. Williams, patients with a larger umbilicus benefit more from this single-site approach, as he can hide the entire incision in the lower umbilical fold. The standard laparoscopic approach (without the robot) utilizes three trocars, but the incisions are much smaller. They measure only 1-centimeter at the umbilicus and two smaller 5-millimeter incisions in the upper abdomen. This also results in a near scarless cholecystectomy.
Even during an emergency, an open incision for gallbladder surgery is rarely required. For this reason, a patient should seek out an experienced and educated laparoscopic surgeon to perform their surgery. Although gallbladder surgery is one of the most common general surgeries, if the surrounding anatomy is harmed including the common bile duct, disastrous effects may result for the patient. It’s been clinically proven that patients who have damage done to their common bile duct during surgery have shortened lives compared to patients who are not harmed.
Being an outpatient surgery, overnight stay is not required the day of your gallbladder surgery. At Capital Surgical Associates, patients are usually in and out within a three-hour window. We've found about half of our patients choose to return to work in two or three days. The other half take about a week off to recuperate.
When You May Want to Call Your Surgeon's Office: Recovering Complications
The day after your surgery, you should be up and moving around easily, however, you will most likely feel soreness at the site of the trocar, as well as in the right upper quadrant of your abdomen. If you experiencing any of these problems, calling in and being seen after surgery may be necessary:
- Increasing Pains
- Unrelenting Nausea and Vomitings
- Fever greater than 101 degrees Fahrenheit
- Increasing redness at the incision sites
On the evening of your surgery and the next day, you may experience low-grade fevers such as a 100.4 Fahrenheit due to the lungs not being fully expanded. A low-grade fever is not necessarily a reason to be seen early. This condition is called atelectasis. By breathing and stretching your lungs you can help treat it. After any surgery in which you undergo general anesthesia, a low-grade fever often results if the lungs are not fully expanded, breathing deeply and coughing helps resolve this problem. General anesthesia is required for gallbladder surgery.