The case for gallbladder surgery :
From anatomy, you know that the gall bladder is a little green sack tucked just beneath the lower rim of the liver on the upper right side of the abdomen. The liver makes bile, which flows down a duct to the duodenum where it participates in the digestion of fats. On its way, some of the bile takes a side trip down a different duct and is stored in the gallbladder.
About 10% of people make gallstones in the gallbladder. However, only about 1 to 2% of these have symptoms of nausea and pain following a fatty meal due to a stone blocking the path of the bile in the common bile duct on its way to the gut. We usually don’t treat asymptomatic patients with gallstones. However, once the patient has a few episodes of gallstone obstruction, the odds of continuing attacks increase even if the patient is on a fat restricted diet. A diet without some fat is pretty boring. We then reach a point of decision, with two options: medication or surgery.
In western medicine, we also have a pill that can dissolve gallstones (it may be an extract from the Chinese herbs). This requires twice a day dosing and takes months for the stones to dissolve. There are several problems with this. First, the stones can recur within five years; second, the medication has side effects; third, as the stones are reduced in size, they are more likely to get into the common bile duct and cause the symptoms that the medication is trying to prevent. Finally, a small percentage of gallstones that get stuck in the duct can result in a bacterial infection, which can cause a blood infection, perforation of the gallbladder and even death.
Gallbladder surgery used to be a much more grim affair than it is today. The patient ended up with a rather large slash across the upper abdomen, up to two weeks in the hospital and a total recovery time of six weeks before he could resume work.
We now live in the age of laparoscopic surgery. Under a general anesthesia, the gall bladder and stones are removed through a small incision with the use of a periscope like device. This is usually done as a same day procedure. When performed by a competent surgeon, the complications are extremely low. In most cases, the patient is able to return to work in a day or two. Once the stones are completely removed (sometimes there is a “retained” stone immediately following surgery), gallstone formation stops for good.
So this brings up the question: is the gallbladder necessary for a healthy life. The answer is... apparently not. The best explanation of why we have a gallbladder is that it stems from prehistoric times when our diet was higher in animal fat and the extra dose of bile helped to aid digestion. In modern times our diet is much more varied and there is sufficient bile produced and delivered to the gut for normal digestion without the gallbladder.