Do I Need My Gallbladder Removed?
The majority of patients with gallbladder stones have no symptoms. Many are found incidentally after having a CT scan or an ultrasound for other reasons. Approximately 15-20 % will develop symptoms in their life time.
Those patients with gallbladder stones that get to developed symptoms will usually complain of dull abdominal pain in the right side of the abdomen just below the rib cage. The pain usually radiates to the right shoulder or mid back. The pain can be associated with nausea and vomiting.
Gallbladder stones symptoms usually happen after eating a fatty meal. A fatty meal is not only something fried. It could be a salad but if you put to much cheese, olive oil, avocado or any other fat containing condiment your symptoms can be triggered.
Other symptoms could be indigestion, bloating, chills, sweating, heartburn, chest pain, and regurgitation. The pain or other symptoms commonly start 1-2 hours after the meal and they can last several hours. In uncomplicated cases, the pain comes and goes and it naturally becomes more frequent and more intense. In some cases the pain becomes constant and patients present with an inability to tolerate any type of food.
Some patients with gallbladder stones will develop complicated symptoms. This is the patients that will get admitted to the hospital with significant pain, and signs of gallbladder inflammation and/or infection.
The gold standard test for the diagnosis of gallbladder stones is an ultrasound. The ultrasound is the most sensitive test to visualize gallbladder stones. It can also detect gallbladder wall thickening, fluid around the gallbladder and gallbladder distention. These are usually signs of gallbladder inflammation.
Another common test is a CT scan. Only larger stones will be visualized and signs of inflammation will be seen on a CT scan.
A more specific gallbladder test is a HIDA or PIPIDA scan with ejection fraction. This test will diagnose complicated cases of gallbladder stones and it will also measure the gallbladder function.
Most patients will also have a routine blood test to evaluate the bilirubin in the blood and other liver function test. Elevated white blood cells can be indicative of gallbladder infection.
Most patients with gallbladder stones symptoms will undergo surgery to remove the gallbladder. The gold standard is a laparoscopic cholecystectomy. The surgery is done with four small incisions ranging in size from 5 -12 mm. Using a monitor and special instruments the gallbladder is removed. The operative time is around 30 minutes for uncomplicated noninflamed gallbladders to several hours for infected necrotic gallbladders.
Routine laparoscopic cholecystectomies are ambulatory surgeries. Complications are possible but the rate nationwide is very low. Dr. Angel Caban has done hundreds of this operations and his complication rate is well below the national average. In complicated cases, the surgeon might convert to the old fashion open approach requiring a large incision and a long hospital stay.
In almost ten years as a surgeon, Dr. Caban has only converted one laparoscopic gallbladder surgery to open. This includes a wide variety of straight forward gallbladder surgeries to nasty necrotic ones. He has also witnessed many other community surgeons that lack his advanced laparoscopic skills convert multiple gallbladder surgeries.
Past performance is not indicative of future results but if you have gallbladder surgery with Dr. Caban your chances of complications is very low.
Laparoscopic Gallbladder Surgery
What If I Had Previous Open Surgery?
Patients with a prior history of open surgery might not be a candidate for a laparoscopic approach with other surgeons. Dr. Angel Caban has extensive experience with complex laparoscopic intraabdominal surgery. Most patients will be a candidate for laparoscopic gallbladder removal surgery in the hands of Dr. Caban.
Recently Dr. Caban completed a gallbladder removal surgery laparoscopic in a patient with a prior history of a gunshot wound to the abdomen requiring multiple abdominal surgeries.
In cases like the one above you should expect to have a longer operative time and/or more than 4 small incisions but even in that case your recovery will be faster and you will have less pain than if your surgery was done open.
What Happens After Gallbladder Surgery?
After surgery, you will be in the recovery room for 2-3 hours. You will be discharged home with several days supply of pain medication. Most patients that have office type job can expect to return to work after 3-4 days. For those of you that have a heavy labor job were heavy lifting more than 15-20 pounds is necessary, you should account for 4-6 weeks out of work.
You will follow up with Dr. Caban in 2-3 weeks. At that time you will get the results of the gallbladder pathology. Gallbladder cancer is very rare but approximately 1% of all gallbladder surgeries will be positive for cancer.
Most patients won’t notice any changes from not having the gallbladder. A small percentage of patients will experience transient or chronic diarrhea especially after eating a high-fat diet. Most patients will go back to eat a normal diet, but some will need to limit the fat content on their diet.
What People are Saying
“Dr. Angel Caban performed my surgery almost 5 years ago on 6/2/2014. He is a kind doctor and always treated me fairly. I always felt welcome in his office. I recommended him to many over the past 5 years”.
“Me encanta no lo cambio. Exelente el doctor caban y su personal. Muy buen grupo”.
“Another successful experience”
“Dr. Caban did my colon resection and did an outstanding job all the way across the board. I highly recommend him as well”.
“Very fortunate to have him”
“I have the privilege of working with Angel M Caban in the hospital environment. I also have had him be the surgeon to one of my family members. I would like everyone to know that he is a great surgeon. We are fortunate to have him here in Ocala. He is personable, easy to talk too and has excellent bedside manners”.
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