November 9, 2019

Most people pay no attention to their gallbladder until it becomes a problem. But once there is an issue, the pain associated with gallbladder problems can often cause discomfort that is impossible to ignore. Identifying the symptoms and knowing when to seek a doctor’s advice are important as many gallbladder issues when left untreated, can create major complications.

What is the gallbladder and what is it for?

The gallbladder is a pear-shaped organ found below the liver in the upper right side of the abdomen. The gallbladder collects and stores bile, which helps to break down fat and contributes to the absorption of fat-soluble vitamins and nutrients into the bloodstream. The bile is delivered to the small intestine through tubes called bile ducts. When the gallbladder is healthy, the process happens painlessly. However, when something goes wrong with the gallbladder or ducts, considerable pain and discomfort can occur.

Symptoms to take note of

Anyone with gallbladder symptoms should seek medical attention, especially if you’ve had gallbladder problems before.

• Pain in the right upper abdomen, back or right shoulder: Pain in these areas is the most common symptom of a gallbladder problem. It can be mild and occur occasionally or quite severe and frequent.

If you have mild, intermittent pain that seems to go away on its own, you should make an appointment with your doctor to be examined further. Usually this symptom does not need immediate attention, but you should be checked out by a medical professional for proper diagnosis.

Symptoms you shouldn’t wait on

Should your pain be severe and consistent—lasting 5 or more hours—and include any of the following, talk to your doctor right away:

• Nausea or vomiting: Most issues with the gallbladder can cause nausea or vomiting. Chronic gallbladder disease may cause digestive problems such as acid reflux and gas.
• Fever: An unexplained fever signals an infection in the body. In conjunction with other gallbladder symptoms, a fever can indicate a gallbladder problem or infection. The infection should be treated before it worsens as it can become life-threatening if it spreads to other parts of the body.
• Bowel movement changes: Problems with the gallbladder can often change normal bowel habits. Frequent, unexplained diarrhea or  more than 4 bowel movements a day for at least 3 months may indicate gallbladder disease. Lighter colored or chalky stools and dark urine are common signs of issues with the bile duct.
• Jaundice: Yellowing of the skin, or jaundice, occurs when liver bile does not reach the intestines successfully. This can occur with a problem to the liver of if there is a blockage in the bile ducts.

What could be the problem?

• Gallstones: The most prevalent cause of gallbladder pain is gallstones. Forming in the gallbladder, gallstones are small, hardened deposits formed from the cholesterol found in the bile of the gallbladder. Other, rarer types of gallstones, called pigment stones are formed from calcium bilirubinate produced by the body to break down red blood cells.

Gallstones can go undetected for years as they are often very small—only a few millimeters wide. It is when the gallstones grow large enough to block channels outside of the gallbladder that problems and symptoms occur. Called gallstone attacks, the sudden pain in the upper portion of the belly can indicate a blockage that can cause problems such as inflammation, infection, and a perforated gallbladder.

• Cholecystitis: When bile can’t leave the gallbladder, cholecystitis, or inflammation of the gallbladder, occurs. When the bile duct is blocked, the bile builds up, irritating the gallbladder and leading to swelling and possibly infection.

Chronic inflammation will result with several acute cholecystitis attacks that may damage the gallbladder and prevent it from functioning properly.

• Bile duct stones: Bile duct stones are either gallstones stuck in the bile ducts or stones that have formed there. This blockage prevents the release of bile to the small intestines to help digest food. Continued blockage of the bile duct causes a buildup of waste leading to a serious bacterial infection called cholangitis.
• Empyema: A small percentage of those with gallstones may also develop an abscess  of the gallbladder called empyema. The development of pus, also called an abscess, leads to severe abdominal pain, and left undiagnosed or untreated, can become life-threatening if the infection spreads to other areas of the body.
• Acalculous gallbladder disease: Gallstones aren’t the cause of every type of gallbladder problem. Acalculous gallbladder disease may present symptoms commonly associated with gallstones without actually having gallstones.
• Gallbladder or bile duct cancer: Gallbladder cancer is very rare and affectsless than 4,000 Americans per year. Rare and hard to diagnose, gallbladder or bile duct cancer can mimic the symptoms of other gallbladder issues or may not present any symptoms until the cancer has spread.

Gallbladder diagnosis and treatment

Gallbladder problems are best diagnosed by your doctor. Ultrasound, blood tests and a physical exam are the most common practices of diagnosis.

The only completely effective treatment of gallstones is a surgery called acholecystectomy. A laparoscopic cholecystectomy involves a minimally invasive approach to removing the gallbladder with gallstones. It is a common operation and, as the gallbladder is not necessary for a healthy life, people go on to live normal lives after gallbladder removal.

Minimally invasive cholecystectomy

A laparoscopic cholecystectomy is performed by inserting a tiny video camera and special surgical tools through 4 small incisions. The camera allows the surgeon to noninvasively see inside the body of the patient. Use of robotics, such as the da Vinci robotic surgery system gives the doctor improved maneuverability and a high-definition 3D camera for better visibility and more range of motion. With the video projected on a screen, the surgeon is able to direct the surgical tools to remove the gallbladder effectively and efficiently.

Once the gallbladder is removed, you may undergo an imaging test such as an X-ray or ultrasound to check possible gallstones or other issues with the bile duct. When the doctor is satisfied, your incisions will be sutured and you will be sent to recovery.

A cholecystectomy carries only a small risk of complications and most patients return home the same day.

Complications and risks include:

• Bile leak
• Bleeding
• Infection
• Injury to nearby structures
• General anesthesia risks such as blood clots and pneumonia

Though complications are rare, it is important to follow the doctor’s advice and care instructions. Most patients find full recovery and are allowed to return to normal activities within a week.

Looking for the right surgeon for your gallbladder needs?

Gallbladder problems must be treated. If you are worried about any signs or symptoms, contactDr. Andrea Pakulaat RMI Surgical.Dr. Pakula is one of the most sought-after practitioners of minimally invasive surgical approaches using the state-of-the-art da Vinci robotic surgery system and she specializes in cholecystectomy.

Dedicated to the treatment, education, and research of both open and robotic techniques, Dr Pakula specializes in various open and minimally invasive and robotic techniques and trains surgeons around the country.