What Are Gallstones?
The gallbladder stores bile, a fluid made by the liver. Bile helps digest fats in the foods you eat. Gallstones form when certain substances in the bile crystallize and become solid. In some cases, the stones don’t cause any symptoms. In others, they irritate the walls of the gallbladder. More serious problems can occur if stones move into nearby ducts – such as the common bile duct – and cause blockages. This stops the flow of bile and can lead to pain, nausea, and infection.
Gallbladder problems can cause painful attacks, often after a meal. Some people have only one attack. Others have many. Common symptoms include:
- Severe pain or aching in the upper abdomen, back, or right shoulder blade
- A dull ache beneath the ribs or breastbone
- Nausea, upset stomach, or vomiting
- Jaundice (a buildup of bile chemicals in the blood), which causes yellowing of the skin and eyes, dark urine, and itching
If your stones are not causing symptoms, you may choose to delay treatment. But if you’ve had one or more painful attacks, your doctor will likely recommend removing your gallbladder. This prevents more stones from forming and causing attacks. It also helps prevent complications. After the gallbladder is removed, your liver will still make bile to aid digestion.
If You’re Pregnant
Hormone changes during pregnancy can make bile more likely to form stones. If your gallbladder needs to be removed, your doctor will talk with you about the timing for surgery. In some cases, it can be delayed until after childbirth. In others, you may have surgery during pregnancy. This helps protect you and your baby’s health.
Treating Gallstones if you’re pregnant
- Gallstones are treated only if you have symptoms. Sometimes your doctor may simply want to monitor your condition. If treatment is done, it may include medication, ERCP, or surgery.
Medication can be given by mouth to dissolve some kinds of small stones. But it takes time for the medication to take effect. Stones may return. Medication is most useful for people who cannot have surgery.
ERCP (endoscopic retrograde cholangiopancreatography) uses a thin tube with video and x-rays to locate stones and remove them from the common bile duct. ERCP may be done alone. Or it may be followed by surgery to remove the gallbladder.
Surgery is done to remove gallstones and the gallbladder.
- Laparoscopic cholecystectomy uses small incisions to locate and remove the gallbladder.
- Cholecystectomy uses a larger incision to remove the gallbladder, and is more effective for removing stones in the ducts.
Having Laparoscopic Cholecystectomy
If you have painful attacks caused by gallstones, your doctor may recommend removing your gallbladder. This can be done using a type of surgery called laparoscopic cholecystectomy. People who have this procedure usually recover more quickly and have less pain than with open surgery.
- Stop taking aspirin, ibuprofen, and naproxen as directed. Ask your doctor what to do if you take prescription blood thinners such as Coumadin (warfarin)
- Have any tests, such as blood tests, that your doctor recommends.
- Don’t eat or drink anything after midnight, the night before your surgery.
The Day of Surgery
- Arrive at the hospital or surgery center on time. You will be given an IV to provide fluids and medication.
- An anesthesiologist will talk with you about the medications used to prevent pain during surgery. Laparoscopic cholecystectomy is done using general anesthesia. This lets you sleep during the procedure.
During Laparoscopic Surgery
Small abdominal incisions are made to insert the laparoscope and other instruments.
You doctor views your gallbladder on a video monitor.
Discharge Instructions for Laparoscopic Gallbladder Surgery
You just had your gallbladder removed laparoscopically. This is a procedure performed through several small incisions. After surgery, be sure to have an adult drive you home and follow the guidelines on this sheet. Make a follow-up appointment as directed by our staff.
For the first 24 hours after surgery, you may not have much of an appetite or feel able to tolerate heavy foods. We encourage you to keep up with your liquids. As your appetite increases over the next few days, you will find yourself eating normally. A low fat diet is initially recommended until you gradually resume your normal diet.
Prevent Future Symptoms
Once gallstones are dissolved or removed from the ducts, you may be able to prevent them from returning. How? By eating a low-fat diet. This means limiting your use of high-fat meat and dairy products and vegetable oils. Read food labels to be sure they’re low in fat.
You will be out of bed the day of your surgery. After your discharge, you may be up and around as you desire, but should avoid overly strenuous activity for several days. You may walk and climb stairs in moderation. You may resume normal activity, including driving a car, after three to four days. However, you should avoid heavy lifting for two weeks.
You will be given a prescription for pain medication. Take this as directed for post-operative pain. If you are experiencing only mild discomfort, you may find that over-the-counter medication, such as Tylenol (acetaminophen) or Advil/Nuprin (ibuprofen), may be all you need for comfort. If constipation becomes a problem, a stool softener (Metamucil) or a mild laxative (Milk of Magnesia) may be taken.
Bandage and Incision Care
You may remove the bandages and shower 24-48 hours after your surgery. Leave the white steri-strips in place. The steri-strips may get wet. NO TUB BATHS or swimming until after you are seen in our office. Gently pat the incision dry after showering. You may re-apply simple bandaids if you wish. You may notice a slight drainage (usually pink or reddish in color) or bruising at or around the incision site. This is normal and not a cause for concern.
You will be seen in our office 7 to 10 days after your surgery and again in several weeks. Prior to surgery, you should have made an appointment for your first post-operative visit. If for some reason that appointment was not scheduled, please call our office at (703) 359-8640 as soon as your return home to schedule your appointment.
If Difficulties Arise
Please call us if any problems or questions arise. We can be reached any time, including evenings and weekends, by calling our office number (703) 359-8640
Call your doctor if you have any of the following:
- Fever over 101F or chills
- Increasing pain, redness, or drainage at an incision site
- Vomiting or nausea that lasts more than 12 hours
- Prolonged diarrhea