Once an individual has their gallbladder removed, they may have the assumption that they can no longer get gallstones. While getting gallstones after a cholecystectomy (removal of the gallbladder) is rare, it can occur and will require medical treatment. To understand how gallstones can return after gallbladder surgery, it is essential to understand the function of the gallbladder and how gallstones are formed.
Located just under the liver, the gallbladder is connected by the common bile duct to the liver. The liver produces bile, goes into the gallbladder and is then stored in the gallbladder. When we consume food, the gallbladder contracts and releases the bile through the common bile duct which finally travels into the small intestine. Bile is a fluid-like substance that helps our body digest the fats in the foods we consume.
Cholesterol in the bile forms deposits that resemble stones that can range in size from a tiny grain of sand to even golf ball size. These deposits are known as gallstones. While almost everyone has gallstones, only a portion of the population will develop complications from having these deposits. These complications occur when the gallstones block or become lodged in the duct, blocking the flow of bile.
Symptoms can range from minor to severe pain in the upper abdomen, upper back pain, nausea, and/or vomiting. Many times individuals may believe they are experiencing major indigestion and do not seek medical attention until the pain becomes unbearable. If the symptoms become reoccurring and begin to cause severe pain, a patient will usually undergo a cholecystectomy or gallbladder removal. While there are several procedures that can be done to find the formation of stones, I had a simple ultrasound that clearly showed the gallstones including the size.
After surgery, the bile will flow from the liver, through the common bile duct and into the small intestine. Because bile has to be produced for our bodies to work properly, stones can again become a problem. Although these stones will not be found in the gallbladder since the gallbladder has been removed, they can form in the bile ducts. This condition known as choledocholithiasis can cause the stones to travel and cause blockage of the pancreatic duct if left untreated.
ERCP (endoscopic retrograde cholangiopancreatography) is used to locate the stones in the bile ducts and can safely be removed. During this procedure, an endoscope is inserted down the throat and into the stomach until it reaches the small intestine. A light and camera at the end of the endoscope guides the surgeon and a dye is released into the bile duct so that the area becomes more visible. A small basket located on the endoscope will trap the stones and they are safely removed.
Since having a cholecystectomy, I have personally not had any side effects or any long-term problems. However, my doctor did educate me after my surgery about what causes the stones, the risk factors I have and how maintaining a proper diet was essential to prevent any further complications. Avoiding high-fat foods and keeping track of your cholesterol levels is important to preventing deposits formed by bile.
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