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When It’s Time to Remove the Gallbladder

medical illustration showing the pancreasWhat is a gallbladder attack, and how will I know if I had one?

Most patients know that something is very wrong when they have a gallbladder attack, also known as acute cholescystitis. The pain is often compared to the labor of childbirth. The attack is caused by a sudden inflamed condition of the gallbladder. The National Institutes of Health (NIH) says that approximately ninety percent of these attacks occur as the result of gallstones, or cholesterol and bilirubin pigments which fuse together. These stones block bile flow of the cystic duct, which forces bile to collect in the gallbladder. The symptoms of an acute attack include extreme pain in the abdomen, nausea, and elevated body temperature. These symptoms can also result from gallbladder tumors. This is a serious medical emergency that requires medical attention. Contact GI-North right away!

What are the causes of this disease?

NIH suggests that diet plays a large role in the development of this condition for some people. Obesity or rapid weight loss can cause problems.

Will my doctor take out the gallbladder to stop the pain?

If your symptoms are severe, it’s best to head to the hospital emergency room. Once confirmed the physician takes preventive measures to avoid unnecessary complications, such as infection and/or perforation. Your condition must be diagnosed before treatment can begin. This step includes ruling out other causes of the symptoms.

Some of the diagnostic tests include liver function testing (LFT). These blood tests are first performed to determine the presence of gallbladder disease. The doctor checks the level of amylase/lipase in the blood to learn if the pancreas is inflamed. Amylase and lipase are pancreatic enzymes. The doctor will also order a complete blood count (CBC) to evaluate the white blood cell count. Elevated white cells suggest infection.

How does the doctor confirm the diagnosis of gallbladder attack?

GI-North will perform diagnostic tests. You’re likely to have an ultrasound test so that the doctor can see the gallbladder and surrounding organs. Alternatively, the medical team may order an x-ray of the abdomen to look for gallstones and other evidence of gallbladder disease. You may also have a computer tomography (CT scan) or a HIDA scan, also known as cholescintigraphy. This test uses hydroxyl iminodiacetic acid, a radioactive material, to measure the gallbladder’s function. An MRCP (magnetic resonance cholangiopancreatography study) may be requested to provide the doctor with close detail of the gallbladder and surrounding organs. An ERCP (endoscopic retrograde cholangiopancreatography study) uses a throat-entered tube to view the stomach and small intestine. The study uses dye to contract the gallbladder ducts, pancreas, and liver.

Do I have an operation if the diagnosis is confirmed?

Not necessarily. Dr. Cofrancesco may order antibiotics to be taken by mouth or through an IV tube if you’re in the hospital. This medication reduces the possibility of infection. If symptoms don’t improve within twelve hours, antibiotics may be given to help your body heal.

What will happen if the symptoms persist?

When symptoms don’t improve, it’s likely that the gallbladder will be surgically removed. GI-North usually schedules the surgery within two days but sometimes it’s necessary to stabilize the patient’s health. He or she may have other health conditions. Complications such as common bile duct inflammation, gallbladder perforation, abscess, or pancreatitis make immediate surgical removal necessary.

What happens during surgery?

Cholescystectomy, also known as removal of the gallbladder, is performed when presence of acute symptoms of an attack persist. This procedure is also used to remove malignancy of gallbladder polyps that may occasionally present. The pain of an acute attack is so severe that patients may say they’ve never experienced such extreme pain. Often, the pain progresses from the front of the abdomen to the right side and the back. Laparoscopic surgery is the standard method used to remove the gallbladder.

Is this procedure painful?

Some patients say that the surgery provides great relief when compared to the level of pain experienced in the acute attack.

Will I need downtime?

Yes. Some patients need a few days, and other need a week or longer to recover. Because this surgery is performed with a laparoscope today, the patient’s recovery time is much shorter than in past years. It’s important to ask Dr. Cofrancesco about how much time you’ll need to feel better.


Gallbladder disease can occur suddenly or symptoms related to a poorly functioning gallbladder may come and go. Patients in the greater Atlanta metro area, including Cumming, Alpharetta, Johns Creek, Suwanee, and Dawsonville, should call Dr. Cofrancesco and staff to arrange an appointment: (404) 446-0600.

© 2014 GI North Gastroenterology Services. All rights reserved.

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