Gallstones

 

 

Hi: I have been reading that some patients after having WLS need to have their gall bladder removed. Has anyone experienced this situation ? Shouldn't the gall bladder be removed at the same time you're having WLS ?

Tenacious 88

I had no gall bladder problems before the RNY, but developed problems afterwards. It's not unusual. As I understand it, removal was sort of standard in the old days of WLS, but insurance companies have stopped paying for the gall bladder removal at the time of WLS unless there is a documented reason to do it.

For many, myself included, it creates another surgery. However, that said, getting rid of the gall bladder was the turning point for me in how I felt. Once it was out, I was a happy camper again. It's probably coincidental that my other issues such as strictures and general inability to eat cleared up about the same time. But in my mind, the gall bladder surgery was the real beginning of my "rejoining the world of the happy and content."

By the way, many surgeons prescribe Actigal as a preventative for this issue. Mine did not, but from what I've seen online many do, much like many prescribe antacids as a matter of course.

Hi: Kenhud 1 
                      It's always about the Ins companies. I feel if the doctor is already in your belly, just have the gall bladder removed to prevent going back into surgery and adding more cost to surgery, but no ! Glad you're doing good now. I'll have to ask my dr. about having the gall bladder removed before vsg surgery. Thanks for your post. Stay well.

Tenacious 88

The cool thing about my local support group is about once every 3-4 months one of the WLS surgeons will come and answer questions!!  I asked this same question to him.  What he said made sense from the surgeons side.  He said about 30% of RNY patients need their gall bladder removed post WLS.  He said they used to take them out at the same time, but stopped doing it unless it was necessary at the time.  He said if it is removed at the same time and the patient develops complications...where is the problem...You have 2 areas you have to search...was it the WLS or the gall bladder??  You would hate to have them have to go back for exploratory surgery to find out.  So they do them one at a time now...

That makes sense. When troubleshooting it is always best to limit the variables.

Hi: Cabin 111
                     I'll accept that explanation. That's why it's so great to have folks like you out there that have asked the same questions I have. The surgeon is right on the money. Now, is there a test to see if your gall bladder is functioning correctly ? In the past I had kidney stones, not to painful, passed them without any problems. One at the time is the way to go. Thanks for your help.

PS. 111 is my mom's lucky number, she plays it all the time and has won many times. Please continue doing well.

Tenacious 88 (Florida)  

Also, clear access to the gall bladder usually requires at least two more ports (read: holes cut in your gut).

More areas for infection and hernia.

Since the gall bladder usually doesn't end up coming out in the long run, why increase the risk of the primary surgery?

Hi: Docd

             The best thing is to do one surgery at a time and see how you do. Hopefully you'll not need a second surgery.

Thanks:

Tenacious 88

Gal Stones are a common complication of rapid weight loss.
I suffered a week of terrible pain around Easter.  an ultrasound revealed that I had several gal stones.. I went to see a surgeon but the pain I described (lower in my belly) was not typical of gal stones. He wondered if there was a problem with my Gastric bypass surgery that was creating the symptoms so he ordered a cat scan.  The cat scan revealed that my innards (RYN) was perfectly fine.. Thankfully I've only had one more Gall bladder attack BUT unlike kidney stones, gal stones don't go away.. and will likely create problems down the road.. so they've scheduled gal bladder removal for me on Dec 22.
It's considerably less invasive surgery than RYN and I felt fine 2 days after my bypass surgery.. so I'm hoping that I won't be too incapacitated for Xmas.. and I didn't want to delay the surgery since I wanted the "bullet holes" healed by the time we go for our Carribean vacation in February.
I thought that gall bladders were routinely removed with Gastric bypass in the states. In Canada the gall bladder is only removed with RNY if you'd had problems prior to surgery.
It does seem ridiculous to undergo two surgeries but I guess I see the reasoning in waiting to see if gall stones do become an issue or not.
J