Gallbladder Function, Disease, and Removal Surgery

Understanding the Role of the Gallbladder

The gallbladder is a small, pear-shaped organ located just under the liver on the upper right side of the abdomen. It serves as a reservoir that stores and concentrates bile, a digestive fluid produced continuously by the liver.

During digestion, the gallbladder contracts and releases bile through ducts into the small intestine. Bile helps break down and absorb fats from food. Removal of the gallbladder is one of the most common surgeries performed today.

Anatomy of the Gallbladder

The gallbladder consists of three main sections - the fundus, body, and neck. The fundus is the round bottom portion, while the body tapers into the neck which connects to the biliary tree.

The gallbladder wall has three layers - an inner mucosal layer, a middle muscular layer, and an outer serosal layer. The muscular layer's contractions push bile out of the gallbladder.

Bile Production and Storage

The liver produces bile and releases it in small amounts continuously into the biliary system, including the gallbladder. Between meals, the gallbladder stores and concentrates bile by absorbing water and electrolytes.

During digestion, hormones trigger the gallbladder to contract and release concentrated bile through the cystic and common bile ducts into the duodenum of the small intestine.

Gallbladder Problems and Disease

Gallbladder disease is most often caused by the formation of gallstones, which are hardened deposits of digestive fluid that can block ducts. Chronic inflammation and infection can also affect the gallbladder.

Symptomatic Gallstones

Gallstones cause symptoms when they move into ducts and obstruct bile flow, leading to gallbladder inflammation or infection. Pain in the upper right abdomen or back, nausea, vomiting and fever may result.

A gallstone attack typically lasts 1 to 4 hours. Jaundice can occur if stones block the common bile duct. Gallstone complications can become life-threatening and require emergency surgery.

Chronic Cholecystitis

Repeated gallstone attacks and obstruction lead to chronic inflammation of the gallbladder, called cholecystitis. The inflamed gallbladder may contain stones, sludge and infected bile.

Recurring pain, digestive issues, nausea and jaundice are common. Chronic cholecystitis sometimes resolves with conservative treatment but often requires surgery.

Gallbladder Cancer

Cancer of the gallbladder is rare but has a poor prognosis. Risk factors include gallstones, chronic infection, old age, obesity, and smoking. Symptoms mimic benign gallbladder disease so cancer is often advanced at diagnosis.

Surgical Removal of the Gallbladder

Cholecystectomy, or gallbladder removal surgery, is the standard treatment for symptomatic gallstones and severe gallbladder disease. It is one of the safest and most routine operations done today.

Laparoscopic Cholecystectomy

Laparoscopic surgery is the most common technique, requiring only small incisions. The surgeon inserts a camera and instruments through ports in the abdomen and removes the gallbladder using minimally invasive methods.

It carries low risk and allows quicker recovery than open surgery. Patients can usually leave the hospital in 1-2 days and resume normal activities within a week or two.

Open Cholecystectomy

Open removal through a larger abdominal incision is only done in certain cases today. It may be required if the laparoscopic approach is unsafe for technical reasons or with severe complications like gangrene.

Open surgery typically means a longer hospital stay, more pain, and a recovery period of 4-6 weeks. But the long-term outcome is generally similar to laparoscopic removal.

Cholecystostomy Tube Placement

A small percentage of patients are too ill for immediate gallbladder removal. For them, a cholecystostomy tube is inserted to drain the gallbladder and relieve the acute problem.

This temporary measure stabilizes the patient until elective surgery can be performed. The external drainage tube is removed once the infection resolves.

Diet and Lifestyle After Gallbladder Removal

Most people adjust without issues after cholecystectomy and can eat a normal diet. But some need to implement long-term changes due to digestive difficulties.

Low Fat Diets

Following gallbladder removal, bile release is less controlled. Some find high fat foods lead to nausea, gas, or diarrhea. A low fat diet helps manage these symptoms.

Meals should contain no more than 3-5 grams of fat per serving. Focus on lean proteins, fruits, vegetables, whole grains, legumes and low fat dairy.

Small, Frequent Meals

Eating smaller portions 5-6 times per day can aid digestion. Large, high fat meals are harder to digest without the storage and release functions of the gallbladder.

Pay attention to food intolerances and avoid triggers. Keeping a food journal helps identify problematic items.

Staying Active and Maintaining Weight

Exercise aids digestion and prevents weight gain, which could worsen post-surgery symptoms. The guidance is typically no heavy lifting for 4-6 weeks after surgery.

Walking and gentle core work can start sooner. Check with your surgeon about appropriate activity timelines.

Though adjusting eating patterns takes time after gallbladder removal, most people find an approach that keeps symptoms minimal so they can enjoy their favorite foods again.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.