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Cholecystectomy

(Surgical removal of the gallbladder)


The gallbladder

The gallbladder is attached to the underside of the liver and stores bile, which helps us digest fats. To understand the gallbladder, it helps to know the function of bile in the digestive system.

Bile is made by the liver and delivered to the intestines through a series of bile ducts. These ducts resemble tiny branches and are sometimes referred to as the biliary tree (see illustration). The "trunk" of this tree is the common bile duct. Bile from all the smaller ducts feeds into the common bile duct, and from there, the bile flows into the small intestine to help dissolve fats.

Gallbladder and surrounding anatomy (diagram)

The cystic duct is a branch off of the common bile duct that leads to the gallbladder. The function of the gallbladder is to store and deliver bile when it is needed. When the stomach receives foods that are high in fat content, it sends a hormone signal to the gallbladder to contract, delivering bile into the intestines to help with digestion.

Removal of the gallbladder

Gallbladder disease consists of obstruction or infection and is usually (though not always) caused by gallstones. In most cases, the best treatment for gallbladder disease is to surgically remove the gallbladder. This procedure is known as a cholecystectomy.

Often the gallbladder can be removed with a minimally invasive (laparoscopic) approach, using small incisions, a telescoping camera, and specialized instruments. The surgeon carefully dissects the gallbladder away from surrounding structures such as the bile ducts, intestines, blood vessels, and liver, and removes the gallbladder through a small incision at the belly button. With this minimally invasive approach, patients can usually go home the same day of surgery.

Sometimes, however, gallbladder removal requires an open approach (i.e., traditional surgery with a larger incision), especially when the patient has other medical problems such as liver disease or a history of many previous surgeries. If you are considering a cholecystectomy, your surgeon will consult with you about which approach is best for your case. (Sometimes a surgeon begins with a laparoscopic approach but encounters conditions that necessitate converting to an open surgery.)

Occasionally the gallbladder is removed for other reasons such as injury or cancer. In these cases, a specialized surgeon may perform the operation to remove all of the involved tissue and associated lymph nodes, or, if needed, to reconstruct or repair bile ducts. This generally requires an open-incision approach.

What happens after my gallbladder is removed?

The gallbladder, like the appendix, is one of the rare organs that can be surgically removed without compromising bodily functioning. Once your gallbladder is removed, the bile produced by your liver will flow directly into the small intestine, allowing continued digestion of fats. Until your digestive system adjusts, you may temporarily experience more frequent and/or loose bowel movements. This rarely persists beyond a few days or weeks, and can be controlled with medications if necessary. Many patients do not experience any changes, as their gallbladder was not functioning properly before its removal.



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