By Aziz Sadiq, DO, General Surgeon—Virtua Surgical Group

Most people don’t think about their gallbladders. That is, until they’ve eaten a spicy, greasy or fatty meal and then find themselves in the emergency room with vomiting, indigestion, and sharp pain in the upper right abdomen. It usually only takes one bad gallbladder attack before people decide to have their gallbladder removed.

What is the gallbladder?

The gallbladder is a small, pear-shaped organ located below the liver. The liver produces bile, which helps the body digest fats. The gallbladder stores bile and releases it into the small intestine to aid digestion. Substances in the bile can harden and deposit in the gallbladder, forming a fine sludge or stones that range in size from pebbles to golf balls. 

Some people have gallstones, have no symptoms, and therefore, don’t need surgery.

The gallbladder attack symptoms often start when gallstones slow or obstruct the flow of bile out of the gallbladder. The symptoms of a classic gallbladder attack include:

• Sudden, intense pain in the upper right abdomen
• Sudden, intense pain in the center abdomen (below the breast bone)
• Pain between the shoulder blades
• Pain in the right shoulder
• Nausea/vomiting

Some gallbladder attack symptoms resolve after 1-2 hours. However, most patients usually only find complete pain relief when the gallbladder and gallstones are removed.

Thanks to modern medicine, most gallbladder removals (also called cholecystectomies) are done laparoscopically, using minimally invasive surgical techniques. Laparoscopic gallbladder removal provides immediate symptom relief. And, the minimally invasive approach helps people recover from major abdominal surgery in just weeks. 

Can the gallbladder really be removed through a one-inch incision?

Gallbladder removal is done using a minimally invasive technique that only requires 3 half- to one-inch incisions. Each incision serves as a ‘port’ that allows the surgeon to insert and manipulate miniaturized surgical tools. These tools include a laparoscope, which is a special camera that provides a magnified view of the inside of the abdomen; forceps for grasping and holding tissues; scissors to separate and remove the gallbladder from the liver and small intestines; and, other tools used for suction or bleeding control. 

Before the gallbladder is removed from the body, it’s placed into a plastic bag and sealed. This helps prevent infection as the gallbladder is removed through one of the small incisions. The surgeon often closes the incisions with stitches that can be absorbed by the body. 

On average, minimally invasive gallbladder surgery takes 30 to 45 minutes, and patients go home the same day. While each patient is different, most recover from the surgery within 1 to 2 days and resume activities like work, driving and exercise within 2 to 3 weeks.

As surgeons refine techniques, more gallbladder surgeries may be done through only one or two incisions. Surgery through one incision would require a slightly larger incision, but leaves a patient nearly scar-free.

How can you live without a gallbladder?

May patients ask how you can live a healthy life without a gallbladder, especially since the bile produced there helps the body digest fat. Back in the day of hunting and gathering, when food was scarce and meals were inconsistent, the gallbladder stored extra bile to help break down a diet that was mostly fat and protein. Now, because people regularly eat about 3 meals a day that consist of carbohydrates, protein and fat, they don’t need the excess bile for digestion. And, even without the gallbladder, the body can still digest these foods normally.   

What are the risk factors for gallstones and gallbladder attacks?

Those who are at highest risk for gallstones and gallbladder attacks include:

• Women
• Women who are pregnant or postpartum
• People age 40 and older
• People who are overweight or obese
• People who have a family history of gallstones
• People who have experienced rapid weight loss

Lifestyle issues also contribute to gallstones including eating a high-fat, high-cholesterol, and/or low-fiber diet and living a sedentary life.

To schedule a consultation with a Virtua surgeon, call 1-888-847-8823.