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  • Q&A with Australian Health Practitioners

    Should I have my gallbladder removed?

    Related Topics
    Crohn's Disease & Ulcerative Colitis Gallstones Pain
    Last year I began having a series of intense pain in my abdomen. X-rays showed "faecal loading of the colon, primarily involving the caecum and ascending colon". GP tested for Celiacs disease (negative) and Crohn's (one of the two antibodies was present). Eventually, the intense instances of pain disappeared, but the oily foul-smelling stool remained. GP referred me to a gastroenterologist, who said he didn't think Crohn's, based on our discussion. Colon- and endoscopy showed nothing abnormal. Oily, smelly stools went away for the most part, but now it's almost impossible to have a Bowel Movement...push, strain for not much "reward". Gastro referred me to gallbladder specialist. HIDA scan showed "borderline low/normal contraction following fatty meal simulation". Ejection fraction was 43%. I was planning to go forward with the removal until I started reading other people's results with much lower ejection rates. Recommendations? Other things I should be considering?
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    • Dr Robert Gandy
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    Dr Robert Gandy

    Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon, Upper GI Surgeon (Abdominal)

    I am a specialist Upper GI, Bariatric, HPB and general surgeon, specialising in minimally invasive surgery. I also offer gastroscopy and colonoscopy to both public … View Profile

    I would assume that ultrasound of your gallbladder revealed no gallstones.  I also assume the pain you were having was not classical for gallbladder pain.  Fatty stools, espeically after large fatty meals can be a sign of gallbladder issues and it sounds as though GP and gastrenterologist have been thorough.

    I advise people with symptoms which are atypical gallbladder pain and symptoms that there is a chance that removing the gallbladder may have no benefit, even if they have gallstones.  Many surgeons would consider your ejection fraction to be in normal range (over 35%) and without gallstones, this would decrease the chance of gallbladder removal improving your symptoms.  

    However, the decision to undergo surgery is about comparing the risk of surgery and balancing that against the chance of benefit, and this discussion is best done in person, after fully reviewing all of your symptoms and results.  I wouldn't recommend rushing into a decision.  sometimes a journal of your symtoms and food intake can be helpful in looking for triggers. If you are unsure, see your surgeon and let them know about your concerns and discuss further. A second opionin from another gallbladder surgeon could help you decide.

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