Gallbladder Surgery Long-Term Care (2024)

Many people do not experience any long-term effects of gallbladder removal surgery (cholecystectomy) and live a normal life without the organ. However, some people experience persistent issues known as post-cholecystectomy syndrome.

Long-term effects of gallbladder removal include diarrhea, fatty food intolerance, gas, heartburn, nausea, vomiting, jaundice, and intermittent episodes of abdominal pain.Symptoms of post-cholecystectomy syndrome typically begin in the postoperative period, but can also begin months or years after surgery.

This article discusses the long-term effects of gallbladder removal. It also discusses potential treatments for the symptoms of post-cholecystectomy syndrome.

Long Term Benefits

Your healthcare provider may recommend gallbladder removal if you have gallstones or if your gallbladder is inflamed or infected. Gallbladder removal is also recommended for people with cancer of the gallbladder.

Removing your gallbladder can help resolve uncomfortable symptoms such as:

• Pain that can be constant or worse after meals
• An uncomfortable feeling of fullness
• Nausea and vomiting
• Fever and chills

Gallbladder surgery, in most cases, prevents new gallstones from forming and eliminates the pain associated with gallbladder disease. For some people, however, symptoms may persist, and additional treatment may be required.

Your healthcare provider will recommend changes to your diet in the weeks following surgery, such as avoiding fried foods and eating more fiber. Many people find that making these changes permanent can help them feel healthier and avoid digestive issues in the long term.

Post-Cholecystectomy Syndrome

Having adverse symptoms after gallbladder surgery is referred to as post-cholecystectomy syndrome.

Symptoms

People with post-cholecystectomy syndrome may develop new symptoms or symptoms similar to those they experienced before surgery. These long-term effects of gallbladder surgery may appear just after surgery, but can also develop months or years later.

Symptoms may include:

• Fatty food intolerance
• Nausea
• Vomiting
• Flatulence (gas)
• Belching
• Indigestion
• Diarrhea
• Jaundice (yellowish tinge to the skin and whites of the eyes)
• Episodes of abdominal pain

According to a 2018 study, having a cholecystectomy did not relieve a person’s symptoms in as many as 40% of those who had the surgery. This translates to nearly 280,000 people (out of a total of 700,000) each year who do not experience a complete absence of symptoms after gallbladder surgery.

A systematic review of those with long-term post-cholecystectomy syndrome was conducted to guide providing treatment for this population. In this study, gallstones that did not get removed the first time a cholecystectomy was performed (as well as new gallstones that formed after the initial gallbladder surgery) accounted for up to 23% of post-cholecystectomy symptoms.

Treatment

Adjustments to your diet and eating habits may help relieve symptoms of post-cholecystectomy syndrome. However, many people who experience long-term effects of gallbladder surgery caused by residual gallstones must undergo a second surgical procedure to remove those that were left behind. Residual gallstones are commonly found in the common bile duct (CBD).

Gallbladder Remnant

Sometimes a portion of the gallbladder is left behind during a cholecystectomy; this is called a gallbladder remnant.When a person has a gallbladder remnant, gallstones can continue to form in the gallbladder.

Symptoms

Symptoms of gallbladder remnant may include:

• Abdominal pain
• Indigestion
• Jaundice

According to a 2018 study, incomplete removal of the gallbladder after cholecystectomy is the most common reason for these symptoms to occur after a gallbladder removal procedure.

Treatment

Gallbladder remnants are removed surgically during a procedure called a completion cholecystectomy. This type of surgery may be done through open surgery or laparoscopic surgery. An open surgery is one performed through a large incision in the abdomen. Laparoscopic surgery is a less invasive procedure where a camera and surgical instruments are inserted through smaller incisions.

Cystic Duct Stump

The cystic duct is approximately 1.5 inches long.It’s part of the biliary system that allows bile to travel from the liver to the small intestine.Once the gallbladder is removed, the cystic duct is no longer needed and it is usually detached at a point that is very close to where it joins the common bile duct.

Sometimes a small portion of the cystic duct is left behind. This is called a cystic duct stump. Acystic duct remnant isa term used when the size of thecystic ductfollowing cholecystectomyismore than or equal to 1 centimeter (0.39 inches).

It is possible for a stone to form in the cystic duct stump. This condition is considered an uncommon cause of post-cholecystectomy syndrome.

Symptoms

A cystic duct stump may cause the following symptoms:

• Abdominal pain
• Indigestion
  
• Jaundice
• Recurrent acute pancreatitis
  

Treatment

This condition may be managed with a completion cholecystectomy, which has traditionally been done through open surgery. It is now becoming more common for the cystic duct stump and stone to be excised during a laparoscopic procedure.

Digestive Issues

After gallbladder surgery, long-term care is usually minimal. Because the liver can still produce enough bile to break down ingested fats, most people live a perfectly normal life without a gallbladder.

The primary difference is that instead of simply getting a bolus of bile after a large meal is ingested, people who have undergone a cholecystectomy have a continuous drip of bile from the liver into the duodenum (the first part of the small intestine).

Although it has not been proven in clinical research studies, some experts point to the probability that the continuous flow of bile acids into the small intestine may increase the risk of gastritis (inflammation of the stomach) and cause symptoms such as:

• Indigestion
• Duodenal gastric reflux

Reflux occurs when the contents of the stomach or bile rise up and irritate the lining of the esophagus.

Managing Symptoms Through Diet

After gallbladder surgery, it's a good idea to keep a food journal or keep notes in a diet app. If a certain food or ingredient causes symptoms, you can take note of it and avoid that specific food in the future.After your gallbladder surgery, pay very close attention to how your digestive system responds to the foods you eat.

Foods that are commonly problematic include:

• Fatty or fried foods
• Spicy foods
• Acidic foods

Be sure to include in your journal how much of each food you eat. That way, you can initially try reducing the amount of a problematic food to see if eating less helps before eliminating the food from your diet.Again, be aware that many of these food intolerances are temporary, so you can try to re-introduce problematic foods later on.

If you experience ongoing symptoms, it’s important to consult with your healthcare provider to be evaluated for any underlying physiological problems that could be causing your symptoms. In many cases, however, diet interventions can help. These include:

• Avoiding coffee, tea, and other caffeinated beverages
• Avoiding any foods that worsen symptoms such as fatty or spicy foods
• Gradually increasing the amount of fiber you eat (such as fruits, vegetables, and whole grains)

Summary

Most people do not experience any long-term effects of gallbladder removal. In some cases, however, people who have undergone this surgery may continue to experience symptoms similar to those they had before surgery.

These symptoms may be caused by gallstones that did not get removed during the surgery or by a gallbladder remnant or cystic duct stump. Although dietary changes may help improve your symptoms, sometimes additional surgery is needed.