Decision Assist

Gallbladder removal

Introduction

The purpose of this tool is to help you decide whether to have your gallbladder removed. When making a decision like this, you must balance:

This tool is not a substitute for professional medical care and advice. Work with your doctor to help you make this decision. A second opinion from another doctor may be valuable. Surgery always carries risks, and you should be fully informed about the risks and benefits of this type of surgery. You should also be aware that research evidence is often limited, and the risks of surgery may not be completely understood. For this type of surgery, there is usually no exact "right" or "wrong" answer.

Your physician may make certain recommendations to you. However, the final decision about whether to have the surgery rests with you.

What is the surgery?

Your gallbladder stores and concentrates a substance called bile. Your liver creates the bile, the gallbladder stores it, and then the gallbladder sends it to your small intestine. The bile helps digest fats.

Gallbladder

You may be considering surgery to remove your gallbladder if you have gallstones, if your gallbladder is inflamed or infected, or if cancer is suspected.

Gallbladder removal is performed while you are under general anesthesia. You will be unconscious and pain-free. It is most commonly performed through several small incisions, using a tiny video camera called a laparoscope.

In laparoscopic surgery, the laparoscope and other instruments are inserted through the small incisions. The vessels and duct going to the gallbladder are clipped and cut. Your gallbladder is removed and the small incisions are closed.

Gallbladder anatomy
Click the icon to see an illustrated series showing gallbladder removal.

Alternatively, an "open surgery" may be performed. A larger incision is made just below the ribs on the right side of your abdomen. As with laparoscopic surgery, the vessels and ducts going to the gallbladder are clipped and cut. Your gallbladder is removed and the incisions are closed.

Endoscopic retrograde cholangiopancreatography (ERCP), along with a procedure called sphincterotomy, may be done to remove any gallstones stuck in the bile duct. During this procedure, an endoscope is inserted through the mouth and passed through the esophagus (food pipe) and stomach, until it reaches the first part of the small intestine.

Key points

How much time this decision tool will take

What this tool will provide


Review Date: 4/7/2010
Reviewed By: Reviewed by A.D.A.M. Editorial: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network (11/7/2007).

References:
  • Siddiqui T. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. Am J Surg. 2008;195(1):40-47.
  • Chari RS, Shah SA. Biliary system. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. St. Louis, Mo: WB Saunders; 2007:chap. 54.
  • Afdhal N. Diseases of the gallbladder and bile ducts. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap. 159.
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