A myth about having the gallbladder removed is that the individual who had the surgery will never have gallstones again. To understand how gallstones are formed and how they can return, we must first understand how the gallbladder works and the procedure that removes it.
The gallbladder is a small sac that is located just under the liver. It stores bile and contracts when we eat to release the bile through the common bile duct which leads to the small intestine. Bile is a fluid that helps the body digest fats. The liver produces the bile and the common bile duct is a tube that connects the liver and the gallbladder.
Gallstones are described as “deposits”, they resemble stones and range in size from a grain of sand up to golf ball size. In most individuals, these stones do not have any effect or cause problems but when the stone blocks a duct, a person can experience mild to severe pain. These deposits develop from cholesterol in the bile. When these gallstones cause major symptoms, a patient will usually undergo a cholecystectomy or gallbladder removal.
The surgery is usually done by laparoscopic surgery where incisions are made in the abdomen and the gallbladder is removed through one of these incisions. In some rare cases, open gallbladder surgery is still performed and laparoscopic surgery may not be an option.
After the gallbladder is removed, the bile flows from the liver and through the common bile duct and into the small intestine. Rarely are there any long-term or side effects after surgery. The surgery only greatly reduces the risk that gallstones will return. Although very uncommon, gallstones can again form in the bile ducts. This condition is called choledocholithiasis and if not treated, these stones can move and block the pancreatic duct.
If gallstones form in the bile ducts, the surgeon will use ERCP (endoscopic retrograde cholangiopancreatography) to locate the stones and remove them. ERCP consists of inserting an endoscope down the throat and into the stomach to reach the small intestine. This endoscope has a light and a camera which guides the surgeon to its destination and then a dye is released to help the bile duct become more visible. After finding the stone or stones in the duct, it is trapped in a small basket and removed, all by the endoscope.
Since having a cholecystectomy, I have had no side effects or any long-term problems. It was one of the best decisions I could have made. Before my surgery, I lived in pain and was in fear of everything I ate because most foods would bring on an attack. One of the questions I asked my doctor was if my gallstones could return and I was informed that they could come back but just not in my gallbladder because I will no longer have one.