Cholecystectomy, most often done under laparoscopic technique, is a common surgical treatment to eliminate symptomatic gallstones by removing the gallbladder. The gallbladder stores bile produced in the liver and releases it into the intestines as an aid to the digestion of fatty foods. Bile contains cholesterol, which forms the most common type of stones. Blockage of the bile ducts by gallstones produces attacks of abdominal pain, which may progress to infection or pancreatitis. Following the surgical removal of the gallbladder, both acute and long-term symptoms may occur.
Pain
Severe gas pain, possibly referred to one or both shoulders, is a side effect of laparoscopic cholecystectomy. MedlinePlus reports that such pain eases within a few days to one week, and that most people recover from gallbladder surgery in one to three weeks. Sore throat may be a side effect of having a tube placed in the airway during the operation. Focus groups organized by researchers in the Netherlands revealed that patients considered pain a more important factor than physician advice when deciding when to return to work. Other factors included wound complaints, dietary problems and general health. The study was published in the January 2010 issue of "BMC Gastroenterology."
Diarrhea
MedlinePlus reports that a possible symptom following gallbladder surgery is loose stools after eating, which normally lasts from one to two months. The condition sometimes becomes chronic, however, and may be due to the laxative action of increased bile acids entering the colon. MayoClinic.com states the rate of gallbladder removal surgeries that lead to chronic diarrhea is unknown and that estimates range from 1 to 33 percent. Medications may help, and avoidance of caffeine, sugar and fatty foods is advised.
Changes in Stools
Rarely, injuries to the biliary ducts during surgery may cause stools to be a gray color. Bright red or dark blood in stools may be a symptom of colorectal cancer, the development of which has been associated with prior cholecystectomy. A study conducted at the Dallas Veterans Affairs Medical Center in Texas, published in the November 2009 "Southern Medical Journal," examined the records of 1234 male patients with an average age of 64 who had adenoma, a cancer that begins in colorectal polyps. Patients who underwent cholecystectomy were 51 percent more likely to have colorectal cancer than men who had no history of gallbladder surgery. Furthermore, the greater the length of time since gallbladder surgery, the more likely cancer was in an advanced stage. Because the study was large and controlled for confounding factors, the authors concluded that prior gallbladder removal is an independent risk factor for the development of adenomatous polyps and that more advanced cancer is associated with longer postoperative intervals. Scientists think that alterations in bile components following cholecystectomy may increase the presence of carcinogenic chemicals, or that the same factors that lead to the development of gallbladder disease may also lead to the development of colorectal cancer.
References
- MedlinePlus: Gallbladder removal - laparoscopic - discharge
- "BMC Gastroenterology"; Assessing factors influencing return back to work after cholecystectomy: a qualitative research; Keuss F., et. al.; January 2010
- MayoClinic.com: Cholecystectomy (gallbladder removal)
- "Southern Medical Journal"; A previous cholecystectomy increases the risk of developing advanced adenomas of the colon; Siddiqui A., et al; November 2009
