not to want my gallbladder removed?

[bezinee]

A few weeks back out of the blue found myself in agonizing pain. Ended up in A&E where the dr said he thought it was biliary colic, and I should have an ultrasound.

Went back to GP, who agreed to refer me (after some persuasion). GP said if the scan found anything I'd have to have surgery..

Have now had scan, turns out I do have one, fairly large, gallstone.

After the first attack, I had one other a fortnight later (after eating some deep fried food). Since then, I've been taking ibuprofen and paracetamol 3x a day, and although I've had the odd twinge, no further problems.

My GP, hospital, everyone I talk to, seems to be saying I should have my gallbladder removed - but I'm not sure that's what I want. I'm now being really careful with my diet, have stopped eating chocolate, biscuits, crisps etc and am losing weight (which I feel should help - and because the first attack happened after a chocolate binge).

AIBU to want to avoid the op?

Of course it is 100% your decision as to whether to go ahead. However, I would strongly advise that you have it out, both on my clinical experience but also personal experience after my father had near fatal complications from pancreatitis due to gallstones blocking the biliary tree.

It's great that you are altering your diet and losing weight, and even if you have the OP I'd encourage you to keep going with that. However, you still run the risk of further attacks and also of getting an infection in the gallbladder/biliary tree. As a PP said, this is not only be horrendously painful but will require emergency surgery with a longer recovery time than the simple keyhole (laprascopic) procedure you have with an elective procedure. An even more serious complication is pancreatitis which can range in severity from mild inflammation to life threatening.

My father decided, like you, that he;d rather not have the op and would just attempt to make changes to his diet and lifestyle. All well and good, he lost nearly 2 stone in weight and biliary colic episodes dwindled down to nil over a period of months. Until one night he had sudden onset severe pain, vomiting, fever. Mum took him to OOH GP and he was taken by emergency ambulance to surgical admissions. Within 30 minutes he was in surgical HDU and an hour later in ICU. He had severe pancreatitis as a result of biliary obstruction and had also developed sepsis.

He was in emergency surgery the next morning as he was too unstable to operate that night. He had to be resuscitated during surgery. My mother was told he had a 5% chance of survival. To cut a long story short, despite being in ICU for over 2 months and having a number of serious complications (including renal failure requiring dialysis, a serious lung infection which has left lasting damage, having to have all but a small part of his pancreas removed, damage to his bowel from sepsis which required an ileostomy, to name a few) he survived due to the fantastic medical care he received. Luckily his kidneys have improved so he no longer needs this, although he does have chronic kidney disease and he is now diabetic. He has a number of complicated problems as well. In total he was in hospital for nearly a year. He never recovered enough to go back to work.

Now obviously, this is a rare outcome and most people have far less serious complications but why run the risk? The surgery is pretty safe (obviously not risk free, but complication rate is low) and recovery time isn't too long.

The dr who did my scan said if it wasn't actively causing problems there was no need to remove it. But that contradicts what my GP says

Your GP will have to refer you to the general surgeons, who will decide what to do regarding surgery. Ultimately, your GP does not make the final decision on whether surgery will be offered.

As regards what the Dr who did your scan said- it is correct that if an incidental finding of a gallstone is found (e.g. patient is having a scan looking for something else and a gallstone is found but it is not causing any symptoms) then it doesn't have to be removed.

However, in your case the gallstone has caused symptoms- therefore it is "actively causing problems"- or at least has caused problems. If you had no further attacks over a period of months or between now and the time you see the surgical team then it may not be necessary. The advice, unless you are a high surgical risk, in patients who have been symptomatic is usually to have it removed to prevent complications occurring at a later date.

My BMI was about the same as yours when I had it done and it was fine, done the easy way. I was out of the hospital same day and I could easily have been back at work the day after.

I know you're "controlling" it at the moment, but it could potentially happen any time. It'll hang over you.

And now I can eat/drink normally (although I am getting healthier). Turns out I know a load of people whove had their gallbladder removed and none have had problems with eating after. although obviously some people do its the minority.

You really need to go back and discuss this with the GP, and ask to be referred to a surgeon.

I do not do well under anaesthetic either - it makes me vomit. But the anaesthetist always asks you about past experience when they see you pre-op and can give anti-sickness drugs to help with the nausea during surgery.

There are all sorts of websites telling you that you can dissolve your gallstones using cider vinegar or using "flushes" but this is dangerous and if it were effective, the NHS would be recommending it too.

You have nothing to lose by going back to the GP, discussing the matter and the results of your scan, and exploring your options and getting a proper medical opinion on the risks of hte anaesthetic versus the benefits of the surgery.

I had mine out 2 years ago. I developed gallstones in pregnancy, i went to my gp about the pain and it was written off as the baby laying in awkward positions and afterwards muscular from adopting new postions for breastfeeding. My son was 3 months old when i was taken to hospital in an ambulance. I had severe pancreatitis caused by gallstones. I was told if I'd not gone in then i could have ended up in icu it was that bad. I had my gallbladder removed, a stone had become stuck in the bile duct so it was slightly more complicated than they thought. I spent 15 days in hospital really ill hooked up to iv's for various medications. I know my case was more extreme than some but i wouldn't risk it if i was you.

Jacks how awful for your dad! People don't realise how serious it can become

I'll try and make an appt with my GP for the next couple of weeks and discuss it then. Will suggest they weigh me (I've never been weighed at my GPs) or at least note my weight for BMI calculation.

When I was anathestised previously, the pre op meds made me violently sick. I also took a very long time to come round from sedation, about 18 hours when the norm was 3-4. Repeating any of that scares me, especially because of my size.

I was of the same opinion as you OP. I didn't want the op and thought I could control it through diet. I was very wrong about that.

Long story short I ended up having emergency surgery and nearly ended up with a ruptured gallbladder.

If you have stones (or a large stone) your gallbladder is not functioning correctly. There isn't any alternative to surgery other than putting up with the pain and hoping you don't get an infection.

My advice would be to have the OP. I delayed mine and was begging for it in the end!

I had mine out in February 2010 I think it was, it was the best thing I ever did. From essentially having no life fearing attacks or having attacks lasting all night and having to go in to work because of sickness policies etc... I now eat what I want without worrying!

I had my op as day surgery I was there at 7am listed for 11am, back with my now DH in the room a few hours later and discharged at 5pm. On the way home I craved grapes so was hobbling round the Co-op at 5.30pm. I took 2 weeks planned sickness so handed over to colleagues as if I was on holiday. By the second week I felt absolutely fine. I have a scar in my tummy button, one at the top of my stomach and 2 further ones that have faded.

The only thing I found was when I was pregnant if I was sick on an empty stomach it was just bile coming out. So I have a great image of me stood round the side of hsbc throwing up yellow.

I'm really interested in this as our experience of it has been so different. My DH had an attack last year, I guessed t was gallstones straight away and that was confirmed by an ultrasound which found several stones. He is slim and eats very healthily anyway but was referred to consultant to discuss surgery. He's opted to wait and so far hasn't had another attack (over a year). He's not changed his diet at all but he ate healthily anyway and rarely drinks. No one has yet suggested that it needs to come out urgently as it doesn't seem to be causing any issues. I assume at some point it will get worse though?

Hi OP, I had my gall bladder out after I developed pancreatitis. I went into intensive care for 2 weeks and went onto have the operation about 5 months afterwards when I'd fully recovered.
I had keyhole surgery and was out soon afterwards. I can't remember if it was overnight or the same day, was nearly 7 years ago. I don't have a restrictive diet at all, I was advised not to eat a lot of just high fat foods as it's more difficult to digest the fat without the gallbladder pumping out bile in response to the high fat intake, but you don't need to go low fat as you still have bile being made, it just trickles down so you can digest the fat but more slowly. Obviously if you eat a mix of food types there is a less dramatic reaction by the body to store the excess.
I was heavily overweight at the time although did lose some weight whilst being hospitalised for 2 weeks as I was just attached to tubes. So maybe you could be scheduled in for 6 months time which would give you time to reduce your weight a bit as well as get comfortable with the idea of surgery, I know so many people that have had the op with no problems and a lot with bmi over 30. But from reading your posts it's the focus on anaesthetic risks so I'd prioritise finding out the ideal weight to get down to rather than not having the OP. Good luck. (Have been writing this on and off all morning so hopefully the threads not moved on too far)

You need to discuss it with a specialist OP, not your GP. Your GP will refer you to a surgeon experienced in cholecystectomy and when you see him/her you can have a fully informed discussion with them about it.

They will explain the risks of having and not having the operation. I had chronic inflammation (so as well as the periodic attacks I had low level constant pain), I had pain and attacks no matter what I ate in the end. I'd had gallbladder symptoms since 2008 but it had gone undiagnosed. The longer you leave it the more at risk of chronic inflammation and infection you become. There is also the serious risk of stones getting stuck and pancreatitis, and an increased risk of gall bladder cancer in the long term.

To try and put your mind at rest about the operation; my BMI was 43 when I had it done. I had it done as a daycase (I am normally fit and well) and was home by 6pm. Back at work within 10 days.

I had mine done by a surgeon who also does batiatric surgery; so he was well acquainted with the risks of operating on obese patients. You could always ask to be referred to your nearest specialist bariatric hospital for your operation if you were worried.

I experience low blood pressure after GAs and the anaesthetist was able to manage that well in recovery. As long as you explain your previous issues with GA in the pre-op they will be able to make sure you are well managed. Also I had no pre OP drugs to take, just a bit of gas and air in theatre while they put me out.

When I was anathestised previously, the pre op meds made me violently sick. I also took a very long time to come round from sedation, about 18 hours when the norm was 3-4. Repeating any of that scares me, especially because of my size.

Just reading your post again OP; was that OP a long time ago? 3-4 hours sounds like a long time. The laparoscopic gallbladder OP is usually about 45 mins and you are expected to come round from your GA in a few minutes really, and can expect to spend 30-60 mins in recovery before going back to your bed/bay.

Your scan doctor is correct that gallstones not causing problems can be left. However yours is causing problems. You have had an attack. So your GP is also correct, you will be advised to have your gallbladder removed.

In terms of anaesthetic, a lot has changed since you were a child. Almost no one has a pre med for starters. New anti sickness drugs and anaesthetics have been invented. And a BMI of 40 would be practically routine for a gallbladder op as weight is such a strong risk factor. I was that and still a day case.

NHS website says if they are not causing you probs you can leave it unless symptoms come back. I just checked because this thread worried me a bit. I had a spate of gallstone pain about 12 years ago in my early 20s. I was scanned and they could see stones (and a kidney stone) but nothing further was done. I don't remember any follow up apps tbh so I might have got lost in the system. In the intervening years I've only had one attack about 3 years ago after a Christmas cheese-board fest. I haven't modified my diet and have had 5 DC so my weight has gone up and down a lot. I think I will leave it for now though.

My experience is a bit different to most on here and ties in with yours OP. I had attacks for months, my diet was shocking.. I was eating greasy takeaways/lots of chocolate. They kept me in hospital and wanted to give me the op, but I was put off due to my mum and a friend having it done and then them not being able to digest fat properly afterwards. They eat fatty foods but need to rush to the toilet after. So I ate healthily in hospital (stayed for two weeks) and they stopped. Carried on healthy eating and then went back to eating whatever I wanted and haven't had an attack in 10 years. So in my case I'm glad I didn't do it but I know a lot of people who try and control their diet and it doesn't work.

I am having surgery in the next few weeks. Never had any problems with my gallbladder until I ended up in hospital with acute cholecystitis. Believe me, you do not want that to happen. A week of unremitting pain that painkillers barely touched (including morphine and tramadol). The consultant told me it could happen again at any time or even worse I could develop pancreatitis or a fistula. I am quite terrified of surgery but the potential for gallstones to become life threatening, though low, is very real. A planned surgery is far lower risk than emergency surgery as previous posters have described. When you get an appointment with a consultant, discuss your worries with them. Good luck. If there was a viable alternative to avoiding surgery, I would take it, but there really isn't.

I'm kind of in the same boat of you BMI wise and have a 3cm gallstone which has been there since I've been pregnant with 13 year old DS.

Mine is completely my out this year. Saw GP in November and BMI has to be under 40 for referral which it wasn't then but pretty much is now so I'm going back in another couple of weeks to get my referral.

I should have had mine out years ago as it has impacted badly on my life but I was scared of having going under whilst fat. Lost four stone then got bogged down with sick parents plus dealing with DC so didn't get round to it.

Mine kicks off on average a couple of times a week now. Eggs and cottage cheese are the latest triggers, stress also kicks it off sometimes as well strangely. I'm scared about the operation as have seen a couple of stories of gallbladders fused to livers but it is so coming out this year. I'm losing weight on average about 2lbs a week to prepare for op but doing a lot of walking to try to improve my fitness.

My advice is start working towards getting it out, last thing you want is a medical emergency and I've been an idiot not sorting it before. Tips for dealing with biliary Colic are prescription codeine plus buscopan, heated wheat bag plus tens machine if it radiates to back.

I am scared of surgery, but I'm also scared of there being complications if I don't have it out.

At the moment I have no pain or symptoms at all if I stick to 3x daily ibuprofen and paracetamol. I have codeine but only used it when I had the bad attack. If I slip - one day I was really busy at work / home and forgot to take any tablets, I felt a bit achy, but was fine again once Id taken them. I use a hot water bottle if i have any twinges too.

I'm moderating my diet, but it will take me a really long time to get to a BMI of 30 unfortunately.

I had mine out recently, no regrets.

I still have stomach pain at times though and am still tired. I can't stand up for a long time.

I would go with the medical advice.

A diseased gall bladder can rupture and stick itself to other internal organs. Sorry, once there's a stone there it's ill and ticking it's time away to it's own demise.

I had similar reservations as you OP, as I'd assumed the op was the last option instead of the 1st. It took 10 mths from 1st GP appointment til the op & it came not a minute too soon - I had a severe attack about 3 wks prior to my op when a stone got lodged in my bile duct. I'd suffered 10 years of misdiagnosis.

The OP for me was key hole but with the added complication of cutting into my bike duct to remove the lodged stone - my recovery took about 6 EJ's in total of lying around doing v little (''twas bliss!).

Managing the attacks is something you can do but if you get a stone lodged anywhere you can't just manage that in the same way. It's agony & risks all the serious consequences others have listed.

You can ask all the questions you need to once you get your hospital referral, about concerns you have re GA etc. Any issues you have can be addressed at that point - write all your questions down & ask as much as you need to. Then decide if you don't want to go through with it.

Don't they blast large gallstones with something?

Or am I making it up L

Weeks not EJ's! Dunno where that typo came from!

Friday you are making it up. The smaller fragments would be even more dangerous with higher risks of them travelling into the common bile duct or pancreatic duct and causing serious complications than there are for normal stones.

I think you are thinking of kidney stones.