Bachelor of Medicine and Surgery MBChB (UCT).
Fellow of South African College of Surgeons
Diploma in Obstetrics & Gynaecology
WHAT IS A Gallbladder?
The gallbladder is a pear-shaped pouch that rests below the liver. It collects a green or yellowish liquid termed "bile" that assists with digestion. Gallstones comprise cholesterol, calcium salts as well as bilirubin. These stones usually develop when there's an excess of cholesterol that accumulates in the bile.
SIGNS OF GALLSTONES INCLUDE:
- Dark-stained urine
- Clay-like stools
- Abdominal pain
- Diarrhoea and vomiting
Why do I need to have my gallbladder removed?
Gallbladder surgery is required in cases of acute cholecystitis, jaundice, cholangitis, and sepsis. Acute cholecystitis occurs as a result of a blockage. An infection develops when there’s a blockage in the bile duct. Cholecystitis is a severe medical condition that requires urgent medical attention.
Signs of infection from acute cholecystitis include:
- Intense upper abdominal pain on the right side
- Fever or chills
- Loss of appetite
Dr Mitchell performs a physical exam to diagnose gallstones or signs of infection from the build-up of gallstones. She examines the skin and eyes to check for signs of discolouration. Diagnosis is based on results from an ultrasound, CT scan, blood tests or Endoscopic retrograde cholangiopancreatography (ERCP).
- Ultrasound: An ultrasound creates images of the abdominal region to diagnose cholecystitis or gallstone disease.
- CT scan: This test captures images of the abdomen and liver to confirm or rule out gallstone.
- ERCP: This diagnostic method combines the use of a camera and x-ray to examine issues in both the pancreatic and bile ducts.
As a gallbladder surgeon, Dr Mitchell performs keyhole surgery to remove the gallbladder. Before gallbladder surgery, a general anaesthetic is administered. Dr Mitchell makes four tiny cuts in the abdomen and inserts a lighted telescope into one of the incisions. The surgeon inserts ports into the other incisions for the insertion of instruments that include scissors and forceps to remove the organ. She pumps a harmless gas to elevate the abdominal wall for closer inspection of the gallbladder, liver, stomach, small bowel and nearby organs. In some cases, the gallbladder surgeon snips strands of fibrous tissue that form over the bowel or adjacent organs. Once the surgeon removes the gallbladder, she releases the gas before the incisions are sealed with either stitches or staples.
Other forms of treatment include:
- Oral dissolution therapy: This form of treatment involves the ingestion of chemicals to dissolve gallstones. Oral dissolution is recommended for people who are young or overweight or for those who only have a few small gallstones.
- Open cholecystectomy: An open cholecystectomy involves a much larger abdominal cut to remove the gallbladder. Open cholecystectomy is still a safe procedure and an alternative to laparoscopic cholecystectomy.
- Cholecystostomy: For those who are extremely ill, the surgeon will drain the gallbladder and remove any stones.
A nurse will monitor and assist you after gallbladder surgery. It is essential to wait at least twenty-four hours for the anaesthetic to wear off. You must notify the nurse should you experience the following symptoms after surgery:
It's normal to experience stomach pain, but the nurse will administer pain killers should you request it. Shoulder pain is also normal as a result of the gas pumped into the abdomen. The nurse will suggest a slow walk to help ease this pain. Your general pain should subside five days after the procedure.
In terms of your diet, you can switch to solids as soon as you can manage a healthy diet. Before this, however, it’s essential to follow a diet that consists of fluids. Because recovery takes time, you must avoid strenuous exercise for at least two weeks after the surgical procedure to preserve cuts and prevent a rupture.
Contact Dr Mitchell should you experience the following symptoms:
- Abdominal bloating for an extended period
- Discolouration of both the eyes and skin
- Signs of inflammation near cuts such as redness or fluid leaking out
Please note: The information provided above and on this website is for education and interest purposes only. It is not intended to replace a personal one-on-one consultation, nor is it meant to substitute professional medical advice, diagnose or treat any condition. A consultation with a specialist and qualified health care provider such as Dr Mitchell is essential for correct diagnosis and management, as well as to answer any queries that you may have. Never disregard or delay in seeking professional medical advice due to something you have read on this website. Dr Mitchell takes no responsibility for any errors or omissions present on this website and is not liable for any consequences that may occur from a misinterpretation of the information on this website. In the event of uncertainty or an emergency, please visit your nearest casualty.