General Surgery
About 20 years ago when the laparoscopic procedure was first perfected, there was a big bump in the number of gallbladder removal operations in the United States. It made sense there would be an increase since the new procedure was a lot safer for patients and sped up recovery time. But recently there has been another bump in the number of gallbladder removals, both nationwide and in our local community.
What’s more, the patients showing symptoms of gallbladder disease are younger than they ever were before. Gallstones can appear in a person of any age, but the average age when they became a problem used to be when a person reached his or her forties, fifties or sixties. Now, patients with symptomatic gallstones tend to be in their thirties or forties. I’ve even had to remove gallbladders from teenagers. Something is going on.
Gallbladder disease is linked to two other health problems that are on the rise in young people: obesity and diabetes. So it’s not a surprise that numbers are trending upwards. The gallbladder acts as a reservoir for bile, a substance produced by the liver which helps the body digest fat. It’s believed that high-fat diets contribute to the bile becoming over-saturated, causing gallstones to form.
Ironically, rapid weight loss also increases the likelihood of gallstones. So a lot of these fad diets where people drop significant weight in short periods of time are putting people at risk. Women have a slightly higher risk than men, and genetics play a role. All in all, it’s estimated that about 20-25 million Americans have gallbladder disease.
Gallbladder disease can manifest itself in many ways. Occasionally, symptoms may be as minimal as indigestion and frequent belching. More commonly, pain in the mid or upper right portion of the abdomen, usually after eating, is the most common symptom. Gallstones may be present and completely asymptomatic for many years. Larger ones become problematic when they block the gallbladder from releasing the bile. Smaller ones can slip into the bile duct and cause pancreatitis or other life-threatening situations.
Eating right and exercising can help prevent the formation of gallstones. But once you have them the only way to get rid of them is an operation to remove the gallbladder. Almost everyone is eligible for the laparoscopic procedure, where a patient typically leaves the hospital within 24 hours and takes about one week to recover. This compares very favorably to the open method of surgery which requires 3-5 days of hospitalization and about three weeks of recovery time.
Approximately 1 to 3 percent of patients with symptomatic gallbladder disease require the open rather than the laparoscopic procedure. The reasons for this vary but ultimately it comes down to what is safest for the patient. Here at Brattleboro Memorial Hospital gallbladder operations are always done with two board certified surgeons present at the procedure. Laparoscopic operations are very safe but there is about a 1 in 1500 chance of injury to the bile duct. Having two surgeons in the operating room minimizes the risk even further as it allows them to confer with each other and agree on each step of the operation before proceeding.
About half a million people have their gallbladders removed every year. Your body is capable of adjusting and functioning normally without it for the rest of your life, which is a long time for many patients with gallbladder disease nowadays. If you’re experiencing symptoms of gallstones or think you’re at risk for gallbladder disease, talk to your primary health provider about getting an ultrasound. Like so many illnesses, early detection of gallbladder disease can help save your life.
Dr. Thomas H. Lewis is a board-certified surgeon and a Fellow in the American College of Surgeons. He practices jointly with Dr. Gregory Gadowski and Dr. Joseph Rosen at Brattleboro General Surgery, a member of BMH Physician Group. He can be reached at 802-254-5510.
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