Is gallbladder surgery really necessary?

Is gallbladder surgery really necessary?

You may not need your gallbladder removed after suffering gallstone pancreatitis.

That’s according to a recent study published in the American Journal of Gastroenterology, in which researchers examined 17,000 cases of gallbladder pancreatitis.

Your gallbladder is responsible for storing the bile produced by the liver, which is transported via ducts to the small intestine to aid in digestion. Sometimes, gallstones – deposits of cholesterol or bilirubin, a bile component, that form due to an imbalance of these substances – may become lodged in a pancreas duct, preventing bile from exiting the gallbladder. This blockage leads to the pain and inflammation known as gallstone pancreatitis.

Typically, in order to prevent recurrence of a gallbladder attack, the organ is removed in a one-month time span after pancreatitis.

Of the 17,000 cases studied, researchers found that nearly 80 percent of participants who suffered an attack had their gallbladder removed within one month, but 3,700 patients did not have it removed within the recommended time frame. Still, 1,200 underwent removal within six months, and four years later, there were still 2,500 patients who had not had their gallbladder taken out.

Study authors believe there is hope to individualize care and eventually determine a way to avoid gallbladder removal surgery.

Dr. Brian Blumenstein, gastroenterologist at Advocate Christ Medical Center in Oak Lawn, Ill., welcomes the research but is realistic about its implications.

“It’s always good to try and define ways to limit surgical intervention. Conducting studies that seek to minimize medical interventions are great because surgery has risks. If you could find a way to say people don’t need surgery for a specific situation, you can eliminate the risk of surgery complication altogether. The problem is that while it is intriguing to see that there is a subgroup of people who do not require surgery after acute pancreatitis, we have no way of determining exactly which patients would fall into it.”

But Dr. Blumenstein says this study certainly sparks interest, but urges that you keep in mind that the recommendations have not changed and that surgery is the treatment plan for gallstone pancreatitis.

“This is just a hint to say that there is a subgroup who will do well without a need for surgery, but there is a significant group of individuals who will go on and have another episode of acute pancreatitis or even a potentially life-threatening situation. Hopefully someday soon, we will be able to proactively tell who does and does not require surgical intervention.”

 

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8 Comments

  1. Oh for pity’s sake. Gall bladder surgery is life changing for so many people. There were whole lists of foods I couldn’t eat until after I had it done. Did I really “need” it? Maybe not. Could I have continued to live without having it done? Probably so. But living on fruit snacks and white bread was getting rather tiring. Now I can eat like a normal person. I don’t know what other treatment would have accomplished that. Until and unless there is some other intervention that gets rid of the gall stones, then removing the gall bladder is the best course most of the time. Stop making people worry about having surgery – it can be hard enough to get it when you need it.

  2. Hopefully more research will be published on prevention of gallbladder disease.

  3. I’m glad mine is gone after fearing it was a heart attack.

  4. Kevin Anderson May 4, 2017 at 12:48 pm · Reply

    One year After having mine removed in an emergency situation, going to ER in the middle of the night after enduring 5-6 hours of unbelievable unknown origin pain. I never had any previous symptoms and it just came on like a ton of bricks. Its a little disconcerting to read this surgery may not be needed, exception; most, but for a very small sub-group maybe not. I have had very few if no side effects since, but you do notice that there are some subtle changes internally. I don’t like being told right off that one needs surgery in the middle of the night like that, when Ive been healthy most all my life. But, I am getting older – so you trust in what the doctors tell you. And I’m still paying for it, but I’d rather not go through an unexpected pancreatitis attack like that ever again. If possible. Thank the Lord, the doctors, & nurses of Advocate Condell.

  5. Nice read. Great to see maybe I need an operation, or maybe I can continue to procrastinate in periodic pain until it is determined what else to do. Thank You.

  6. michael scheer May 4, 2017 at 8:52 pm · Reply

    Just because 2500 patients out of 17,000 with gallstone pancreatitis did not have their gallbladder removed after a four year period does not justify this procrastination. Pancreatitis is a potentially life threatening complication of gallbladder disease and is the absolute indication for cholecystectomy. Patients with true gallstone pancreatitis typically require ERCP in addition to laparoscopic cholecystectomy and if they have a recurrence of pancreatitis it is likely to be more complicated not less complicated. If there was a reasonable way to eliminate gallstones without surgery, cholecystectomy would be less necessary but there is not. The ONLY treatment and the recommended treatment for ANY symptomatic gallbladder disease is Laparoscopic Cholecystectomy and this has not changed since 1992! I find the numbers in the study unbelievable as well. 3700 patients did not have surgery in a timely fashion and of these, 1200 had surgery within 6 months, while ALL of the other patients, 2500 were followed for four years and NONE had surgery for gallbladder disease? That is unbelievable. The only exception to the surgical indication should be patients with comorbidities that tip the risk benefit ratio to the risk side significantly. They should be followed carefully because they are already at high risk. It is a general disservice to suggest to patients who have suffered complicated gallbladder disease that they have the option not to undergo the recommended treatment.

  7. I had my gallbladder removed in 1989, the old fashioned way of surgery. Very long incision, gas pains afterward in my shoulders, but the attacks became more frequent and more severe. At that point, I felt, as the surgeon said, it was best to have it removed.So I did. I never have had any problems since then, some 28 yrs. ago. I do suffer from IBS and recently the gastro doc informed me that IBS can be worse w/o a gallbladder. The absence of a gall bladder eliminates the bile to help with digestion and slow down the process of food digestion. This can also contribute to symptoms of making IBS worse causing diarrhea. Interesting to hear that fron her. Too late now

  8. Removal of the gallbladder means there is no place for the bile from the liver to be stored so it drips continuously into the small intestine. Because bile is a salt some people can not tolerate this dripping and have cramps and diarrhea after eating. This is NOT IBS, but irritation of the small intestine from the bile. I suffered from this for 2 years after surgery and no one, not the surgeon or my gastroenterologist knew what was wrong. I heard all that IBS story too and had a lot of unnecessary labs and Xrays. It wasn’t until changing doctors that I was diagnosed with post chole syndrome which is cramps and diarrhea from bile salt irritation. There is a drug called Colestid which absorbs the excess bile so this does not happen. I have been on this for 20 years and you can not believe the number of people that I have told this too over those years who had the same problem and that their doctors did not know this simple solution. One person who I told was my allergist whose husband had his GB out and was having diarrhea all the time. Taking this simple powder mixed in water(or the pill form) I went from not being able to eat anything without having diarrhea to being able to eat anything just by taking this medication.

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About the Author

Holly Brenza
Holly Brenza

Holly Brenza, health enews contributor, is a public affairs coordinator at Advocate Health Care in Downers Grove. She is a graduate of the University of Illinois at Chicago. In her free time, Holly enjoys reading, watching the White Sox and Blackhawks and playing with her cats.

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