totally confused over gallbladders =why not take actigall to prevent removal?

THis weekend alone, I think I have read about a dozen posts about people needing there gallbladders removed or they are having I just dont understand why surgeons just dont give post ops actigall to prevent the stones or take the gallbladder out during the RNY's.  Over the past 3 plus years, I have read  probably thousands of post ops that end up getting there gallbladders out in the 3-6 months and if not, then in the first year.  This makes no sense to me.  I know actigall can tax the liver but I would think that would be worth it rather than having to have another surgery to remove an organ.  Either that or just take it out in the first place so you dont have to take the drug. Your liver can eventually take the function of your gallbladder.

I would love some other opinions.

I know if I still had my gallbladder, I would have incisted that they take it out. I also know that my surgeon requires that all postops take the drug and he sends all patients for a sonogram to see if you have any gallstones or sludge.  If there is any disease, he takes it out

I'm still pre-op but I know that when I do have the RNY my surgeon is taking mine out at the same time. This could be because I'm having it done open rather than laproscopically so he figures "while i'm in there" ...it does make little sense to be fully recovered or just about fully recovered and then need to have another surgery so soon after but they must have their reasons?

My surgeon did give me Actigall to take for the first 6 months post op. Im 5 months post op and have not had any gall bladder issues yet.

Prior to losing weight i had fatty liver disease so taking a drug that was hard on my liver that was already compromised wasn't ideal.

My doctor doesn't remove the gallbladder during RNY because if a patient had complications it would be harder to figure out if the complications were due to the RNY or the gallbladder removal.  That made sense to me.

I did end up having a horrible gallbladder attack 1.5 years after my RNY that landed me in the ER, but I am not upset about the outcome or process.  In my initial consult my surgeon told me that 90% of his patients that still had their gallbladder prior to RNY would eventually need it taken out, so I just assumed it would happen down the road.

Christy

almost all of us have fatty liver disease preop and once we lose our weight, it does go away.  We have fatty liver because we are fat.  I had severe fatty liver and my enzymes were very high.  Thankfully I had my gallbladder out prior to my RNY or I would have still insisted in either having it out.

If they are taking the gallbladder out during surgery and complications arrise, they can tell what the what the complicatoins are from. I think your surgeon just didnt' want to do it.

Just the statement that your surgeon gave you alone that 90% have there gallbladder and end up needing it out is reason enough to either have it out or take the medicine - why have 2 surgeries other than line his pockets.  There is more risk in going under anestesia twice, being cut twice - anything can happen rather just doing all at once.    There are alot doing all at once now because they have figured out that it ends up happening.

I think the reason that a lot of surgeons don't just give patients Actigal is because it doesn't completely lower the risk of gallstones or having to remove the gallbladder.

You risk of having gallstones/gall bladder problems post-opt directly related to the rapid weight-loss is only 40%.  Actigal only lowers that risk an additional 10%.  So even in patients that take Actigal, there is STILL a 30% chance they will have gallstones and require gallbladder removal.  With those kind of statistics, and with all the possible OTHER side effects of taking Actigall, for many people it is not worth it.

Side effects of Actigall: diarrhea, constipation, upset stomach, indigestion, dizziness, vomiting, cough, sore throat, runny nose, back pain, muscle and joint pain, hair loss.

My doctor prescribed Actigal, but I personally don't like taking lots of unnecessary medication that has a marginal effect for what it is prescribed.  For me, the benefits did not seem substantive enough so I did not take the Actigall that I was prescribed.

My surgeon takes them out as a matter of course (at least, he used to; I have no idea what his current practice is) and I think that is a smart move. You can EASILY live without your gallbladder and without any significant health/lifestyle issues, too.

My Dr said the same thing as Christie said above. He doesn't like doing 2 surgeries at once because he cannot pinpoint if issues are related to the RNY or the gall bladder removal. He has patients get their gall bladder out first as a separate surgery previous to him doing the RNY if he thinks it's necessary. In my case, I did have a few gall stones but they were not symptomatic so he left it in. I asked him to prescribe the Actigall but he didn't want to. He didn't think it was effective enough to put all his patients on it. And he did say that losing weight rapidly was already taxing on the liver so he didn't like adding to it. He would rather keep your liver as healthy as possible and risk you needing your gall bladder out later on.

 I really can't give you an educated answer because I haven't had to deal with any gallbladder issues, and hence haven't researched the issue at all.  I'm 2 years 3 months out and haven't had any issues, didn't take actigal and still have my gallbladder.