Dilemma: Gallbladder removal or not?!

I am still sitting on the fence, between keeping gallbladder or not. I do NOT have gallstones best they can tell and do not have hurtful gallbladder pain, but HIDA Scan confirmed a very low functioning gallbladder (7%). I do have digestive issues from time to time, sleep interruptions, fatigue and vitamin absorption issues, but a multi-vitamin such as Centrum was apparently able to take care of the problem.

Now all of my Doctors/Surgeons tell me to remove the gallbladder, except one who says only take it out if the pain is unbearable. A ratio of 3:1.

Below are some of the Pro's and Con's I have compiled:

Pros: To keep gallbladder I may have:
*Bad Digestion
*Waken at Night
*Fatigue
*Other GB diseases that may come up

Cons: To have Cholecysectomy:
*20% Chance of Chronic Diarrhea, cannot Skip Meals
*33% Chance of Ducts of Luschka disease - bile leakage
*Chance of Acid Reflux, Nausea, Belching, Gas - Sensitive Stomach
*Ab Adhesion - Painful - Possible Bowel Obstruction
*May become Gluten intolerant
*Between 10% and 23% still experience pain (may not apply in my case)

Now there are some good chances of recovery:
Most patients (75% - 90%, 95%) diagnosed with biliary dyskinesia (chronic acalculous gallbladder disease) experience partial or complete relief of their symptoms after cholecystectomy.

Further more I may have small stones/sludge/sand that has not been discovered... (Ultrasound & CT Scan so far)


Please let me know your thoughts, or points to add.
I will also try to update the Pro's vs Con's so it may help others in the future.

[gnorb]

Funny. I'm on the same boat (EF = 19%, no stones, pain only when eating fried foods). Talked to 2 docs about it. One said "In your case, most people see almost complete or elimination of symptoms (mostly heartburn in my case; some belching, gas), the other "keep it and if it starts hurting, then chuck it." My mother, who had something similar (hers was dyskinesia, but eventually she developed stones), also went through the heartburn. Got hers out and hasn't had a problem since.

Didn't know about some of the dangers (namely Ducts of Luschka disease), so thanks for the research. I still wonder about getting it out, though, especially during those times when my heartburn flares up (like for the past week: the month before that was pretty much clear).

Good luck

[AlanPi]

Thanks, I wasn't aware heartburn can be part of GB's issues. I only learned that without a GB, the bile can up into stomach causing heartburn, or go into colon causing diarrhea.

I did have heartburn a few years ago, and went through Triple antibiotics to get rid of the H.Plori bacteria.

[gnorb]

H. Pylori was the first thing the docs wondered about when I was shown to have gastritis and heartburn. Nothing there, though: gastritis was caused by too much acid (I guess), which was caused by the gallbladder issues (I guess). I was officially diagnosed with GERD as well, however.

If you don't mind my asking, where do your numbers come from? (Should have asked this before, but forgot.)

[AlanPi]

I have scheduled Cholecysectomy for 7/17 or  8/18 regardless.  Nothing seems to work consistently.  I am on the 2nd pile of Bile Acid Factor we will see.

The statistics come from varies sources, the numbers varies so they could both be listed.  Here are some links:

http://www.springerlink.com/content/c488431j1718741r/
http://www.dlcsurgery.com/id25.html
http://www.cheboygansurgical.com/biliary-dyskinesia-80/

I have a huge spreadsheet with the info I compiled over 3 months almost full time, if you are interested.

[AlanPi]

Here is another link:

http://www.laparoscopyhospital.com/past_present_and_future_of_laparoscopic_cholecystectomy.htm

[Dianeatcpta]

I am also in the same boat.  Just had an ultrasound this morning and I have no stones in the gallbladder or duct.  They also said my gallbladder looked normal with no disease.  I am 39.  My 4th attack in a week that I had last night may not have been stones since there are none in there today.  My doctor friend says I may have biliary dyskinesia.  Still looks like surgery is the treatment option.  There are way too many cons for the surgery and I am completely against it do to anesthesia, scar, and possible side effects.  My attacks are pretty severe lasting 2 to 4 1/2 hours and doubling me over.  Feel like child birth labor pains except you do not get any breaks.  My biliruben results and White blood cell counts were normal but my liver ALT and AST results were high but they did not think I have an infection.  Will get blood test again on Wednesday.  I am thin, workout, and I do not eat a lot of fattening foods because it is too greasy or rich for me.  Are there any alternative treatments for Biliary Dyskinesia?

[AlanPi]

Seems removing BG is the easiest way.  I don't have any pain attacks, just excessive sweating *sometimes*, when eating greasy food.  After gallbladder removal I swill sweats occasionally.

I have not had much of a side effect, now an year and half after surgery.  I do get bile dump if I try to eat foods that are too greasy, like Pizza.  If there are no existing food in the pipeline to soak up the bile, then heading to the restroom is the only option.  So just don't eat foods that are bad for you :-).

Good luck!

[PrettyKiity808]

7% functioning. Get your gallbladder removed because it will get worse from experience.

[Dianeatcpta]

New update:
Blood work 2/2 has elevated AST 245 and elevated ALT 478.  I am on anitbiotics for elevated liver and biliary iinflammation.  Had IV fluids two days in a row because I was not drinking enough and not eating food because I am scared of another very painful attack that lasts hours.  My biliruben, pancreas and thyroid are normal.  I had a HIDA scan which seemed to be normal.  The GI dr said I should probably have my GB taken out but sitll they have not checked everything.  I convinced them to schedule an MRCP for me to look at the ducts.  If that looks abnormal or normal I will probably seek a second opinion because she will probably still want it out.  I want everything checked before I am cut open.  You can still have other problems that cause symptoms when your GB is removed.  Should I have a CT scan also? Any advice from your experience.

[PrettyKiity808]

Yes, some people can still have some pain after the gallbladder is removed. Doctors usually do a CT scan first before they do an ultrasound. An ultrasound shows more.