August 04, 2022
If you or someone you know experiences intense abdominal pain after eating a fatty meal, don’t wait until it requires emergency care. If you are experiencing this pain in the upper right part of your abdomen, see your primary care provider. Their tests can determine if you have stones in your gallbladder or biliary dyskinesia, a disease that causes your bile to not flow freely through your ducts. Gallstones and biliary dyskinesia share similar symptoms.
Your primary care provider will likely recommend modification of your diet as a first treatment for your gallbladder condition. However, when dietary changes don’t work, surgery to remove your gallbladder, called cholecystectomy, may be a good option for you.
The surgery has changed over the years, reducing risk and improving recovery time. Despite misinformation to the contrary, most patients do quite well without their gallbladder. “They regret not doing it sooner,” says William Freund, MD, general surgeon with The University of Kansas Health System. “The risk is low, and we can get patients back to doing what they love.”
Dr. Freund joined us to share what to know about the gallbladder, cholecystectomy and choosing a surgical care team.
What to know about the gallbladder and cholecystectomies
A. The gallbladder is an organ your body uses to store bile. Bile is made by your liver and is used to absorb dietary fat.
A. Intense pain in the upper right of your abdomen is the most common symptom. It may indicate the presence of gallstones, which are commonly formed from deposits of cholesterol. As many as 1 in 6 adults has some type of gallstone. Gallstones are often discovered during an emergency room visit. An ultrasound can help providers identify and assess the gallstones.
Biliary dyskinesia causes similar symptoms. Bile will store in the gallbladder, but not empty appropriately. Essentially, the gallbladder doesn’t work. Patients will be in intense pain. A HIDA scan – an imaging procedure to scan the liver, gallbladder and bile ducts – can help a physician assess biliary dyskinesia.
The scan is done with a tracer, an injection in your arm, that is taken up by your liver, sent to your gallbladder, then ejected out of the gallbladder. A scanner tracks the flow of the tracer through those organs. Medication given during the scan helps your gallbladder squeeze and allows radiologists to measure the gallbladder’s ability to eject the tracer.
Anyone who is experiencing right upper abdomen pain after meals should ask their primary care provider or a specialist about scheduling a HIDA scan.
A. Women are more predisposed to gallstones than men due to their higher body fat composition. Women’s hormones and their cholesterol influence this composition.
Some rare conditions cause red blood cell breakdown, leading many of those patients to electively have their gallbladder removed. Some of these conditions could be familial, so talking to your family about a history of gallstones, biliary dyskinesia, or past gallbladder surgery could be worthwhile. Of note, cancer of the gallbladder is extremely rare.
A. The first therapy for gallbladder issues is modification of your diet – essentially avoiding high fat foods. Those who continue to experience episodic pain should consider the option of gallbladder surgery.
A. A cholecystectomy is surgical removal of the gallbladder. Most cholecystectomies are now done as a minimally invasive same-day procedure. This laparoscopic surgery is done with small incisions and a camera. It is considered a low-risk surgical technique. It also has a faster recovery time and less impact on a patient than an open surgery. Most patients are extremely satisfied with their surgery and can resume many activities within 1 week. Some patients, such as those who have had previous abdominal surgeries, may benefit from traditional open surgery.
A. A good thing to consider when choosing a surgeon is how many of the procedures they have successfully completed. Ask how many gallbladder surgeries they do in a week, month or year. Ask the same question about the facility and your prospective care team. Cholecystectomy is a common, high-demand procedure. However, we understand that having a surgery is a big decision. There is no “small” operation.
A. We are part of an academic medical center and a referral center for primary and specialty providers. Our hepatobiliary fellowship-trained surgeons are prepared to take on the toughest, most challenging surgeries. But it’s more about the entire team dedicated to each disease process. Our health system has made the commitment to the best technology, the best surgeons and the best care teams for patients. From the surgeon and surgical techs to the nurses and coordinators, our team approach makes a significant difference.
A. Start with your primary care provider if you are experiencing pain in your upper right abdomen after eating a fatty meal. If you opt to schedule a surgical consultation with The University of Kansas Health System in Kansas City, a dedicated surgical nurse coordinator will help you choose the best care team and location for your needs. If doing online research, be sure you are reading verified content from professional medical sites.