Gallbladder surgery- wwyd?

[BlueAbacus]

Hi all, I have had two crippling abdominal pain episodes in the last ten days, the most recent one was so painful I called 111 and ended up in a&e. Bloods fine (no inflammation or infection) but diagnosed with gallstones after ultrasound. Doc said they won’t go away and it’s low fat diet or surgery, basically. He advised the NHS waiting list is very long for non emergency surgery right now for obvious reasons, and luckily I have the option to go private due to work health insurance.

My question is, what would you do?

General anaesthetic and surgery terrify me, equally so does this pain (albeit intermittent) being a constant part of my life. I have started reading about diet control but it seems haphazard and in my own, very limited, experience, the night I ate a pizza last week was not the night I had an attack! Obviously I can see the benefit of having it out when I am well and it’s not infected and hasn’t got critical, but it feels a bit like I’m making the choice to have elective surgery.

Not sure if it’s relevant but I’m 35, 2 young children, mildly overweight (just lockdown and postpartum) otherwise fit and healthy.

Any experiences or thoughts would be much appreciated.

Have you actually been referred to an Upper G.I consultant? The protocol at our Trust is to have a OGD camera to check for anything else (once an ultrasound has been done after 6hours of fasting to adequately assess gall bladder and rule something else out)
They don’t tend to advise low fat diets anymore as not always fatty food that affects it, it can be bizarre things like oranges even!
Personally I would ask tour GP to refer you to be seen by an Upper G.I consultant before debating about having your gall bladder out.

@Poppiesway1 yes, sorry if that wasn’t clear. I saw a consultant Gastroenterologist on Friday afternoon and had a (fasted) ultrasound. He was 99% sure it was gallstones before the ultrasound, so explained the surgery to me there and then, rather than (in his words) having to waste time coming back for another appointment. The ultrasound confirmed gallstones and my follow up appointment is tomorrow by phone, when I expect him to give me the option of surgery.

He did suggest low fat in the interim which has worked for the last two days but, you’re right, from my reading this weekend that doesn’t seem like a cure all.

@BlueAbacus ahh I thought you’d only seen the A&E dr. I guess all cons and Trusts have different protocols. Ours just like to make sure there is definitely nothing else going on before surgery.

if the gall bladder wall is slim and not inflamed then it’s a lower priority than those with a thickened inflamed gall bladder wall which is more likely to perf / have complications.

The size of the stones are also an issue (they should have been measured at you scan). Small (talking mm’s) stones are much more likely to travel through the ducts and obstruct, where the bigger stones (generally over 10mm’s) , won’t pass through the gall bladder neck and likely to stay in there, these ones are better to have when gall bladder is removed.

@Poppiesway1 thank you that’s really helpful. I will definitely ask about size of stones tomorrow

Derailing slightly but those of you who have had your gb removed what did your diet look like afterwards please ? I'm bothered you have to live on grilled fish and steamed veg once you have no gb
I'm in the same situation as the OP but so far I've refused to have it removed (partly because at my last appt I was less than 12 months post radiotherapy for a tongue tumour and couldn't deal with the thought of more down time and sick leave) but the consultant did tell me he preferred to remove as an elective op rather than as an emergency when things have moved on massively so as I've started to get bouts of heartburn like symptoms I'm thinking maybe I need to go and get it done

I bless the day I had it done 11 years ago. And it was amazing to have the pain taken away and the worry that I might have an attack when I was driving.
I’d delayed due to fear and listening to relatives.
Towards the end it escalated rapidly and the surgeon said it was difficult to remove. I was lucky it didn’t burst.
So I think it’s great that you are getting it investigated early. Best of luck

@ginislife definitely look into it. I had keyhole surgery and that’s normally just day surgery with a few days rest. I had an overnight stay due to the fact that I’d delayed and it was so full of stones. Even then I was ok after a few days rest and the immediate vanishing of that awful pain. So I agree with your surgeon, better early when it’s not an emergency.
As to post GB op diets, I was given no information on that at all. So I’d be interested to hear what others were recommended to do

Derailing slightly but those of you who have had your gb removed what did your diet look like afterwards please?
My dad had his out many years ago and carried on exactly the same!
Butter, steak, burgers, crisps, chocolate etc.

When I had mine out I didn’t make much dietary change either, i had very mild heartburn pretty much constantly but I haven’t had any heart attack like pain (gallstone attack) since the operation.
I am now trying really hard to eat very healthily, vegetarian and doing lots of smoothies.
But that is because I am grossly obese because of my choices and fed up, not because of my gallbladder. Or lack of.

so far I've refused to have it removed (partly because at my last appt I was less than 12 months post radiotherapy for a tongue tumour and couldn't deal with the thought of more down time and sick leave) but the consultant did tell me he preferred to remove as an elective op rather than as an emergency when things have moved on massively so as I've started to get bouts of heartburn like symptoms I'm thinking maybe I need to go and get it done
You really should get it done.
I suffered with terrible attacks that were like a heart attack - centre crushing chest pain very, very rarely at first.
The ambulance and hospital dismissed it as stress.

It became more severe and frequent and gallstones eventually were picked up but I refused because I was terrified of dying under anaesthetic.

In the end, I got a bad attack, so bad I was sweating, couldn’t talk, couldn’t move.
The ambulance staff were horrible and left me in the chair in the hospital corridor while they told the doctor who had come out that they thought i was just a bit stressed.
It was pure chance the doctor recognised me as I’d only been in less than a week before for the same problem and he got me a bed.

I needed morphine, like a PP my liver and kidneys were starting to shut down and I had to have it out as an emergency because a stone had lodged and I had pancreatitis.

Have it out.

@BigWolfLittleWolf thank you. I do hear what you're saying and you're right. I'll ask for a referral back to the consultant.

A friend had her gall bladder out 30 years ago and she had to take a powder every morning an hour before she ate anything otherwise she had permanent diarrhoea. How do they manage this now ? Bile does something in the digestive process so how do you manage without it ?

Permanent diarrhoea isn't normal afterwards - I found things were a little looser in that department but not problematic and it has gradually normalised

As to post GB op diets, I was given no information on that at all. So I’d be interested to hear what others were recommended to do

Nor was I, I was surprised to read about it about 15 years later! I have a very normal balanced diet.

Get it out, it’s such a straightforward op. Mine caused pancreatitis too beforehand and I was in hospital for a full week in incredible pain- was on morphine and tramadol. Felt absolutely fine after about 3 days.

@ginislife - the liver produces bile, the gallbladder stores it. It emulsifies fat and najes it easier to I had my gall bladder removed 15 years ago and i dont suffer any ill effects. Sometimes a heavily fatty meal might give me the runs but that would probably happen anyway.

I had an MRI scan just after my pre op assessment but obviously now things have been massively delayed. I went to hospital today, they gave me strong pain killers and sent me home, telling me to ring my surgeon about the time scale!

After my gallbladder was removed I returned to a normal diet, 4 days after I had my surgery was Christmas Day and ate as normal but a slightly smaller portion as still recovering. Mine was only referred for an ultrasound after I ended up nearly unconscious on my bosses office floor with the nurse looking after me, it had been triggered by cheese on toast, something I had regularly before and after! Wouldn't mind but I had been treated to my only so far ambulance trip the year before for a gall bladder attack which morphine didn't help with the pain but they ran nearly every test but an ultrasound.

My mum has to be careful with a fatty diet but that is more likely to be linked to the fact she has diverticulitis which reacts badly to fat.

Just a quick update: my surgery is booked for end of next week. Had another attack this morning which I’m still recovering from so I’m hoping to get through the next 7 days without another 🤞🏻. Thank you all for sharing your experiences.

@BlueAbacus

Just a quick update: my surgery is booked for end of next week. Had another attack this morning which I’m still recovering from so I’m hoping to get through the next 7 days without another 🤞🏻. Thank you all for sharing your experiences.

Mine too!!!! I'm still having attacks a week on. I've been in pain for a week! Not as agonising as before but a constant painful niggle, then an attack then subsides. I'm rattling with tablets! Good luck!

Good luck @ballsdeep! Please let me know how you’re getting on afterwards. Hope it’s better for both of us

Fingers crossed that it goes well and you’re much better afterwards.

I had mine taken out 10 years ago, unfortunately for me I've ended up with bile acid malabsorption from the removal of my gallbladder and I wouldn't wish it on anyone. Its completely ruined my life and I wish I hadn't had it taken out.

Glad to see you are having an Op why aren’t you having key hole? Very little invasion.

I was the same age 35 and pregnant when mine was diagnosed one the size of a duck egg! Baby was six months old when I had them out and I was feeling very ill. When he started the Op they discovered I had septicaemia and I had to be flushed with antibiotics and ended up staying for several days. Not something we had planned and DD was breastfed early morning and evenings. DH had to bring her in a couple of times a day.
The surgeon said if I hadn’t had them out I would have died in a day or so. Recovery was quite quick as key hole. Good luck.

@Redsquirrel5 it is keyhole! So likewise hoping for a good recovery. Sounds like you had a lucky escape.
@southern82 that sounds awful, so sorry.

Blueabacus good to hear it is keyhole. I had mine when they had just started doing it. Another surgeon disagreed with the choice once the op started and the septicaemia was discovered. He told me afterwards. I was in surgery for 5 1/2 hours apparently. I was given great after care so hope yours is too. Felt so much better a few weeks after.

Get it done.

I had one gallstones incident, which took me to hospital. They didn’t do much aside from give me painkillers. I sort of forgot about it to be honest.

Then nearly a year later it happened and I tried to manage it myself. After five days I ended up admitted with a severe gallbladder infection, pancreatitis and signs of sepsis.

Eating a low fat diet can help prevent flare ups but that’s not guaranteed, I don’t each much fat and wasn’t overweight (they think mine were caused by medication).

Recovery from the surgery was a bit rough but have never had any issues since.

Bit late to the thread here! I had one episode of gallbladder pain that landed me in A&E but they didn’t find the cause at the time time, then the next month feeling fine and dandy one minute, had a cheese salad, 30 minutes later ended up rushed back to the surgical ward. Massively infected gallbladder, IV antibiotics, emergency surgery and a long and painful recovery. Those people in for elective surgery for it were out same day. Don’t hang around if you can help it.
Hope it gets sorted soon x