Gallbladder surgery

[abcsoup]

I have experienced intermittent right upper quadrant pain for the past 3 years.  Over the past 3 months, it occurs daily, mainly after meals.  A ultrasound showed no stones, an abdominal CT scan was normal, blood tests were normal, however, a HIDA scan with CCK showed my gallbladder ejection fraction to be 16%.  I am seeing a surgeon next week to discuss removal of my gallbladder.  At 16% and having physical symptoms, how likely is it that the surgeon will want to remove it?  Also, my gynecologist wants to do a diagnostic laparoscopy to find out what is causing my right lower quadrant pain.  Would it be possible (if the two doctors can schedule it) to have these two surgeries at the same time?  Thanks much!

[CARUU]

I had gallbladder surgery a year ago.  Due to adhesions from previous colon CA surgery, I had to have open surgery.  I now have URQ pain that I didn't have before surgery, also continue to have extreme GERD (with chest pain, nausea, vomiting bile, belching). I had the gastric emptying test done recently and it came back slow.  Now taking domperidone which seems to be helping some (although it's only been a week).  I wonder if my problem all along was slow stomach emptying and the doc removed my gallbladder because there was 1 stone.  Oh, and they discoverd hepatits c in the process of all this and I just completed treatment in April.  Now undetectable.  What a year!  Does anyone have experience with domperidone? caruu

[Kevin Pho, MD]

With a low ejection fraction, and the fact that the injection of the CCK reproduced the pain, it is likely that the surgeon would want to remove the gallbladder.  There are some smaller studies that suggest that removing the gallbladder relieves the symptoms in those with low ejection fractions.  

Yes, it should be possible to do both surgeries during the same operation.  Discussion with your surgeon should be undertaken to coordinate the procedures.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[abcsoup]

Yes, the CCK injection reproduced my pain.  The tech who did the study noted this also in my charts, for the radiologists and other doctors to see.  My GI dr. met with me once she got the results of my HIDA scan, and she is the one who had me scheduled to meet with the surgeon next week.  The pain now occurs everytime I eat, not only when I eat "fatty, greasy" foods.  I'm hoping the surgeon will want to take it out.  I'm willing to have it done in hope of pain resolution.  I understand that no guarantees can be made, but I'm willing to try it.  Thanks!

[TJV]

  Why would one be eating fatty greasy foods if they had a poorly functioning gallbladder.? Diet modifications are often very effective in alleivating gallbladder pain . If it were me, i would give diet a good chance before opting for surgery.

Have read some studies on aspirin and the possibility that it may inhibit gallstone development as well.   The reduction in the secretion of mucus may inhibit the aggregation of cholesterol crystals, critical to the development of gallstones

[surgeon]

It would be easy to do both things at once. The main question is whether you need your gallbladder out. An important question is this: when the hormone was injected during the HIDA scan to see how the gallbladder squeezes (that's how they figure the ejection fraction), did the injection reproduce your pain? If it did, the chances are good that removing gallbladder will help. If it didn't, then even with a low ejection fraction, the odds of helping are much less. And even with a low ejection fraction and reproduction of your pain, it's not a guaranteed cure. As a surgeon who has removed many many hundreds of gallbladders, I always recommended a consultation with a gastroenterologist in situations where the gallbladder has no stones; in other words, in the absense of stones, even with an abnormal HIDA scan, I believe the gallbladder should be removed only after other explanations have been well ruled out.

[surgeon]

given the info you provided, I'd be pretty sure the surgeon will be willing to go ahead -- I would. And the odds, tho not 100%, are in your favor in terms of getting relief.

[darrinwade]

be prepaired to drop some weight. I had my gallbladder out june 8th and now everything i eat comes out like water and i mean water ive drop 10 LBs in just the last 14 days and i sure hope u dont have it the same. the pain is not that bad just try not to coff that hurts. good luck

[abcsoup]

For the past two months, my previous doctors had told me my pain couldn't be my gallbladder because the ultrasound and CT scan didn't show any stones.  It's not like I have greasy french fries and a fatty steak every day.  When I had my worst gallbladder "attack" thus far, I had eaten a hamburger and potato salad.  Now I get the same pain even when I eat natural applesauce or sugar-free jello.