Surgical Procedures
Gallbladder
What does the gallbladder do?
The liver, an abdominal organ on your upper right side, produces a substance called bile. Bile is the color and consistency of thin motor oil. Bile leaves the liver and travels through the bile ducts on its way to the gallbladder. The gallbladder, a pouch located under your liver, stores and concentrates the bile. The purpose of bile is to break down fatty foods; when you eat a meal, your stomach sends a signal to the gallbladder to release the bile into the small intestines. There begins the first step in emulsifying fats.
What is cholecystitis or cholelithiasis?
Gallbladder disease is usually associated with much pain, which can be caused by chronic or acute inflammation, infection, and/or stones. The inflammation or infection of the gallbladder is referred to as cholecystitis, while cholelithiasis is a term indicating the presence of gallstones. After an individual eats a meal, the gallbladder contracts to release bile. If it is infected or inflamed, pain or nausea will often occur. Sometimes, stones form in the gallbladder, starting off as a tiny particle. Some people have many stones, and others have only one. Stones usually grow to pea-size, but sometimes they are much larger. These cause irritation, pain, or inflammation.
How do I know whether my gallbladder is making me sick?
To make the appropriate diagnosis, Dr. Beutel will do a careful physical exam and a detailed history. In addition, it may be necessary to order some of the following tests, or possibly others: labwork, a gallbladder ultrasound, Hidascan, and/or a C-T scan.
What is the treatment for cholecystitis or cholelithiasis?
Cholecystectomy is a term indicating the removal of the gallbladder. Dr. Beutel will discuss with you whether this is the best treatment for your symptoms. These reasons may include gallstones, chronic or acute inflammation, and/or infection. Just a few years ago, most gallbladders were removed though a 6-inch incision across the abdomen. However, new technology has made it possible for approximately 97% of cases to be done laparoscopically, using a tiny hollow optical instrument with a light at the end that is inserted into the abdomen. Three small incisions are made for the instruments on the upper part of the abdomen. The advantages of laparoscopic surgery include minimized discomfort and a faster recovery time. Most laparoscopic procedures are outpatient operations in which the patient can return home the same day. However, in some cases, an open operation is the safest and best alternative for the patient.
During gallbladder surgery, the patient remains asleep for the entire procedure. Most patients will have laparoscopic surgery, which will result in three incisions about ΒΌ inch long. In the eventuality that Dr. Beutel decides that for your best interest and safety an open operation is the best option, you will have one incision about 6 inches long. The operation usually takes around 1.5 hours, though it may take a little longer. A stone in the common (main) bile duct may require additional procedures after the gallbladder is out.
In order to optimize recovery, it is important to follow the post-operative instructions received from the office. This will include following a low-fat diet.
What are the risks for the operation?
The risks of operation include: possible problems with the gallbladder duct (less than 1%) or the main bile duct (rare), bowel perforation (rare), bleeding and infection. The anesthesiologist will discuss with you the anesthetic risks. Some patients with serious medical problems may have a higher than normal risk.
Related documents: 
Gallbladder post-operative instructions, Low fat diet
