Gallbladder Removal

Just curious, how many fellow NYers here have had their gallbladder removed after surgery or during surgery?  If so how long after?  Also did everyone have an ultraound prior to surgery?  My surgeon says all that  an edoscopy  (along with the other requirements)is needed for me, because I have no gallbladder problems/symptoms.    Is this ok?  Now that I have completed all of my testing I am just making sure everything is right!?  I would appreciate your feedback Thanks in advance Shara-

I went throw the same test prior to surgery and found that I had gallstones,so during surgery had my gallbladder removed. surgery went great .did not have any problems from it. if you have any more questions feel free to write and ask ! hope this is helpful.

Shara, Dr. Kini said that I had to have the ultrasound because I still had a galbaldder. The whole ultrasound sucks. OUCHIE. I am having my endoscopy on July 9th....did u need to bring someone with you for this procedure? My fiance works and family is in PA...so I wouldn't be driving....i'd be taking a taxi.

I still have my gallbladder and I am post op.  I had an ultrasound to make sure everything was good.  I know have to take medicine to make sure I don't develop gall stones, which can happen with rapid weight loss.

I had an emergency gall bladder removal almost 1 year after my RNY. I had gall bladder problems before but the insurance would not pay for it to be removed during my bypass. They said it would be more costly( like a second EMERGENCY surgery and the ER visit was cheaper, let alone there was no rooms at the hospital so they had to give me a private room $$$$$) Yeah, glad they thought it was going to save them money. Let alone now I had to go through yet another surgery, and the risks they put me through.

Shara: It is pretty stanrd to have a gallbladder ultrasound preop, because obesity is commonly a cause of gallbladder disease and rapid wt loss can cause issues s well, so preventatively they lok and see, an ultrasound should not be painful? Not sure what happened to one person here to cause pain? http://www.webmd.com/digestive-disorders/Abdominal-Ultrasoun d?page=2 How It Is Done This test is done by a doctor who specializes in performing and interpreting imaging tests (radiologist) or by an ultrasound technologist (sonographer). It is done in an ultrasound room in a hospital or doctor's office.You will need to remove any jewelry that might interfere with the ultrasound scan. You will need to take off all or most of your clothes, depending on which area is examined (you may be allowed to keep on your underwear if it does not interfere with the test). You will be given a cloth or paper covering to use during the test.You will lie on your back (or on your side) on a padded examination table. Gel will be spread on your abdomen to improve the quality of the sound waves. The transducer is pressed against your abdomen and moved back and forth over it. A picture of the organs and blood vessels can be seen on a video monitor.You may be asked to change positions so additional scans can be made. For a kidney ultrasound, you may be asked to lie on your stomach.You need to lie very still while the ultrasound scan is being done. You may be asked to take a breath and hold it for several seconds during the scanning.Abdominal ultrasound usually takes 30 to 60 minutes. You may be asked to wait until the radiologist has reviewed the information. The radiologist may want to do additional ultrasound views of some areas of your abdomen.

How It Feels The gel may feel cold when it is applied to your stomach unless it is first warmed to body temperature. You will feel light pressure from the transducer as it passes over your abdomen. The ultrasound usually is not uncomfortable. However, if the test is being done to assess damage from a recent injury, the slight pressure of the transducer may be somewhat painful. You will not hear or feel the sound waves. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~  http://www.webmd.com/digestive-disorders/Upper-Gastrointesti nal-Endoscopy an upper Gi endoscopy  is standard as well to look and see how stomach is prior to cutting!watching for tuors, ulcers etc. Some patients develop gallstones after obesity surgery because rapid weight loss is associated with a 30% chance of forming gallstones. During the operation, the gallbladder is checked for gallstones using an ultrasound machine. If gallstones are present, the gallbladder is removed at the time of the surgery. If there are no gallstones, the gallbladder is usually left in place and the drug Actigal is prescribed to prevent stones from forming during weight loss.  ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ (source: 'Obesity Surgery' by Louis F. Martin, 2004 ISBN 0-07-140640-9)

(paraphrased) "Gallstones occur in ~ 30% pts who undergo significant wt loss (regardless of method used medical or surgical). Ursodiol (*generic name for actigall is brand name) increases the solubility of bile salts and reduces the risk of developing gallstones to ~ 25 if taken 300mg FOUR times per day. Once-per day dosing reduces risk to 50%, twice a dday to 25%, three times a day to 12-13%. It is given for 6 months or for as long as pt is losing significant amounts of wt. (more than 3% bodywt a month). There are no other meds, changes in diet, lifestyle that will prevent gallstones to the same magnitude as Urisodiol. It is a large pill and rather expensive, both limit the number of pts who can follow this recommendation." With a standard proximal RNY (which is mainly restrictive mildly malabsorbtive) it is not recommended to remove gallbladder, but it is recommended in Distal RNY and BPD/DS both of which are more malabsorbtive procedures. Still alot of controvery over gall bladder removal (choleycystectomy) prophylactically (preventatively) as it is not without complications...this is why they dont just take everyones out, so ther eis risks taking out and leaving in, but because 2/3 dont have issues and only 10-15% of the 30% bwho develop stones need it out...they dont take them all out INSURANCE companies are not driving this medical scienc is the risk of extending OR time in a MO pt is riskiere usually than waiting and seeing . Ultrasound preop is one way to see if they might need to remove it and once they are in there with surgery they should check also.

Some surgeons do a risk assessment knowing age, BMI, gender, ethnicity, fatdistribution as well as surgical technique all play a role (higher BMI, female, increased age, hispanic, more malabsorbtive procedures and central obesity are all the higer risk indicators). ~~~~~~~~~~~~~~~~ Gastrointestinal Complications of Obesity Surgery John E. Pandolfino, MD; Brintha Krishnamoorthy, BS; Thomas J. Lee, MD Medscape General Medicine 6(2), 2004. http://www.medscape.com/viewarticle/471952_print Cholelithiasis Obesity and rapid weight loss are known risk factors for gallstone formation, and thus, it is no surprise that approximately one third of patients may develop gallstones after bariatric surgery. Furthermore, 10% to 15% of all patients will require cholecystectomy for complaints related to gallstones.^[40-44] Some centers routinely perform cholecystectomies with bariatric procedures to prevent complications of cholelithiasis, whereas other centers choose to administer ursodiol as prophylaxis for 6 months postoperatively. Two controlled trials^[40,45] demonstrated the efficacy of 6 months of ursodiol therapy in decreasing the incidence of gallstone formation. Cholelithiasis was detected in 22% to 32% of controls vs in 2% to 3% of treated patients at 6-12 months.^[40,45] Clinicians against prophylactic cholecystectomy suggest that the operation may increase the overall operative time and length of hospital stay and that a cholecystectomy may be easier to perform after weight loss has occurred.^{[46] Reference:} 40. Miller K, Hell E, Lang B, Lengauer E. Gallstone formation prophylaxis after gastric restrictive procedures for weight loss: a randomized double-blind placebo-controlled trial. Ann Surg. 2003;238:697-702. Abstract  41. Shiffman ML, Sugerman HJ, Kellum JM, Moore EW. Changes in gallbladder bile composition following gallstone formation and weight reduction. Gastroenterology. 1992;103:214-221. Abstract  42. Amaral JF, Thompson WR. Gallbladder disease in the morbidly obese. Am J Surg. 1985;149:551-557. Abstract  43. Deitel M, Petrov I. Incidence of symptomatic gallstones after bariatric operations. Surg Gynecol Obstet. 1987;164:549-552. Abstract  44. Wattchow DA, Hall JC, Whiting MJ, Bradley B, Iannos J, Watts JM. Prevalence and treatment of gallstones after gastric bypass surgery for morbid obesity. Br Med J (Clin Res Ed). 1983;286:763.  45.Sugerman HJ, Brewer WH, Shiffman ML, et al. A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric-bypass-induced rapid weight loss. Am J Surg. 1995;169:91-96; discussion 96-97.  46. Hamad GG, Ikramuddin S, Gourash WF, Schauer PR. Elective cholecystectomy during laparoscopic Roux-en-Y gastric bypass: is it worth the wait? Obes Surg. 2003;13:76-81.  I still have my GB, I lost almost all my wt in 7 months so fairly rapidly and had lost 45# 3 mo prior to wls..u just never know! But what I do know is I am glad they didnt remove mine preop and risk comlications unnecessarily of prolongng my OR time or kicking liver; granted a second surgery is not preferable either but the risk w/ atigal use is very low, its a numbers game!, also After gallbladder surgery, some people have ongoing abdominal symptoms, such as pain, bloating, gas, and diarrhea (postcholecystectomy syndrome) good reasons to keep the GB if u can!!!

I too have to have my Gallbladder out today during my surgery and I had no symptoms but my doc says my gallbladder is full of stones so they are removing during todays RNY. My ultrasound during all my pre-op testing showed the stones so out it comes... Rae

My surgeon, Dr. Holover, requires a Gallbladder sonogram prior to surgery. They would like to rule out any type of Gallbladder disease BEFORE they do your surgery. This way, they can take the gallbladder out at the same time as your weight-loss surgery.  This would hopefully prevent a future surgery to remove your gallbladder.   I happen to have my gallbladder out already, so this is not a concern for me.  I might consider having a sonogram of your gallbladder before surgery just to be safe. It's a non-invasive procedure, so why not? My feeling is, better safe than sorry! Good luck, Lisa

Pretty much what LisaL said is the same for me. I had Dr Garber but I know both require such testing! I endoscopy was nothing really and I felt so good after I woke up   I wish you all the best!!!

I had an ultrasound done, they found stones & removed my gallbladder during surgery. I have had no problems and prior to the ultrasound, I had no symptoms of gallbladder problems. I would ask  my doc for the test to be done, better safe than sorry! Lil