Surgery to Remove the Gallbladder: Is surgery the only solution?

Gallbladder is a pear-shaped organ that stores the digestive juice called bile. Due to the abnormal function of the liver or gallbladder, bile becomes highly concentrated and starts to harden over time and causes gallstones. These stones range from the size of a rice grain to the size of a golf ball. In most of the patients, gallstones do not go away on their own and would require surgery to remove the gallbladder. This surgery is called a cholecystectomy.

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Is surgery the only option for gallbladder removal?

Patients with gallbladder may suffer from symptoms like severe and sharp pain in the abdomen, indigestion, fever, chills, jaundice, and inflammation of the pancreas, etc. So, patients with symptoms should undergo gallbladder removal [either open surgery or laparoscopic surgery] surgery, as it is the only option to treat gallstones. Some of the situations where gallbladder surgery to remove the gallbladder is required are:

Presence of gallstones in the gallbladder
Accumulation of gallstones in the bile duct
Inflammation of gallbladder due to gallstone
Formation of large polyps in/or gallbladder
Pancreatitis [inflammation of pancreas]

But, if a patient is having gallstones and does not show any symptoms, then he/she can avoid the surgery.

Patients with small gallstones can opt for alternatives rather than open and laparoscopic gallbladder removal. However, the doctor may recommend alternatives only after evaluating the severity of the symptoms, and they are:

Shock waves therapy: In the case of small gallstones, shock waves can be used from outside of the body to break down the stones into tiny pieces. So, these pieces can be dissolved or flushed out of the bile duct. This technique is used only in case the gallstones are less than 2cm in size.
Diet changes: Avoid eating fatty foods like cheese, french fries, fried chicken, and microwave popcorn, etc. Eat more nuts like peanuts and cashew as they reduce the severity of gallbladder attacks. Consume high fiber foods like brown rice and whole-grain bread that helps in better digestion.
Lifestyle modifications: Limit the intake of alcohol as it can aggravate the symptoms. Don’t skip the meals as it can lead to the build-up of cholesterol and causes gallstone formation. Drink lots of water that helps to dissolve or flushes the small gallstones. Reduce the weight in case of overweight, as obesity can increase the size and disturbs the normal function of the gallbladder.

Types of gallbladder removal surgeries:

The majority of gallbladder specialists and surgeons will remove the gallbladder in either of the two ways:

Open cholecystectomy: In this surgery, the patient is sedated using general anesthesia. Then, 5-7 inches of large incision is made on the belly. Now, the surgeon will locate the gallbladder and will remove it. Once the gallbladder is removed, the incision made will be stitched together.
Laparoscopic cholecystectomy: This surgery to remove the gallbladder involves making small incisions over the abdomen. During this surgery, harmless gas is filled into the abdomen to create space for the surgery. Later, a laparoscope and other medical instruments are sent into the abdomen to cutoff the gallbladder. Incisions will be closed once the gallbladder is removed.

Benefits of laparoscopic gallbladder removal:

Laparoscopic surgery has some benefits over open surgery and are:

Less discomfort
Shorter hospital stay
Faster recovery of the patient
Minimal or no scars
Less tissue cutting
Less pain after the surgery
Quick healing as scars are small
Avoids exposure of internal organs to external contaminations
Reduces the risk of infection

Take away:

Patients with no sign of symptoms need to change their diet and lifestyle to improve the overall health condition. However, lifestyle & diet changes only prolong the period for the symptoms to show up. So, in the long run, patients with and without symptoms should undergo surgery to remove the gallbladder as it is the only option that can treat gallstones.