Gallbladder Removal

The gallbladder, a small sac under the liver, stores bile. Gallbladder disease is when conditions slow or obstruct the flow of bile, which helps with the digestion of food, out of the gallbladder. When diseased, the best treatment may be gallbladder removal.

Gallbladder surgery can be an open surgery done through an abdominal incision or a laparoscopic one through several small incisions with a small video camera on a scope.

At University of Maryland Medical Center, our GI specialists are experts in performing and teaching laparoscopic procedures. Patients who come to UMMC will benefit from the expertise and experience of surgeons who actually helped to create some of these procedures.

Gallbladder Surgery

Most gallbladder surgery today is done using laparoscopic surgical techniques, in which narrow instruments, including a camera, are introduced into the abdomen through small puncture holes.

Gallbladder surgery is done to treat gallbladder disease such as

• Gallstones
• Infection or inflammation
• Severe abdominal pain due to gallbladder disease
• Blockage of the bile drainage tubes

Gallstones

Often, this surgery is done because gallstones are causing a problem. Everyone who has gallstones does not necessarily have a problem with them. But when symptoms do develop, more often than not the best thing to do is to remove the gallbladder because recurrent symptoms are likely.

Symptoms caused by gallstones are typically pain in the abdomen, usually right under the right rib cage and sometimes right under the breastbone. When this pain comes and goes, often after eating fatty or spicy food, and is due to gallstones, the condition is called "biliary colic." When the pain persists more than a few hours and keeps getting worse, it is called "cholecystitis."

Nausea and a bloating sensation are also common with gallstones, and yellow jaundice of the skin may develop. Jaundice is a sign of a gallstone that may have escaped the gallbladder and is now wreaking havoc farther on down the digestive system. This can lead to severe complications, like pancreatitis, or inflammation of the pancreas.

Laparoscopic Gallbladder Removal

During this laparoscopic procedure, surgeons make several small incisions in the abdomen near the navel and pass surgical instruments and a light source with a tiny camera through them. Surgeons then locate the gallbladder and separate and close off the vessels and tubes from it. They then remove the gallbladder and close the incisions.

Laparoscopic gallbladder surgery requires a shorter hospital stay; usually the patient is home within 24 hours. In some cases you may need to stay overnight. In contrast, patients undergoing open surgery are often in the hospital three to seven days. Other advantages include a shorter recovery time, less scarring and less pain after surgery.

Despite the advantages to the laparoscopic approach, the procedure may not be appropriate for some patients who have had previous upper abdominal surgery or who have certain pre-existing medical conditions. If the gallbladder is extremely inflamed, infected, has large gallstones, or seems to be complicated, the abdominal (open) approach is recommended. We evaluate each patient's case carefully to determine the best type of procedure to perform.