What is the gallbladder?
The gallbladder is an organ under the liver on the right side of the abdomen. The gallbladder stores liquid called bile made by the liver. Bile is sent into the intestine to help digest the fat in foods.
Gallbladder Disorders
There are four main disorders of the gallbladder:
- Gallstones (cholelithiasis)—small solid formations inside the gallbladder that come from bile salts, fats, and bilirubin.
- Inflammation (cholecystitis)—this happens when gallstones block the drainage of bile out of the gallbladder causing swelling.
- Biliary Dyskinesia—the gallbladder does not empty bile into the intestines like it should.
- Gallstone Pancreatitis— this happens when gallstones block the bile duct. This stops pancreatic enzymes from getting into the small intestine. The enzymes irritate the cells of the pancreas (an organ behind the stomach), causing the swelling associated with pancreatitis.
Diagnosis and Treatment
The team will examine your child and will order tests to determine what is causing his/her abdominal pain. Gallstones are commonly diagnosed by ultrasound or other scans.
Gallstones are typically treated by an operation to surgically remove the gallbladder (cholecystectomy). In most cases surgery can be done laparoscopically—this is a minimally invasive procedure done through several small incisions made in the abdomen instead of one large incision/opening. The operation is usually completed in one to two hours. After surgery your child will receive intravenous fluids and pain medication to keep him/her comfortable. Your child must be able to eat, drink and be comfortable on pain medication taken by mouth before going home (usually the day after surgery).
Follow-Up Care
Activity guidelines
Your child can return to school as soon as he or she feels well enough and is no longer taking prescription pain medications (usually within 3-4 days). Your child should not participate in physical education or sports for 2 weeks.
Hygiene
Your child may shower one day following surgery. Let mild soap and water run over incision sites and gently pat them dry. No soaking in a bath for 1 week following surgery.
Wound Care
Wash with mild soap and water only. Do not use ointments or creams. Your child will have either Steri-Strips or surgical glue on the incisions. Steri-Strips will slowly come off on their own as your child bathes and can be completely removed after 7-10 days. Surgical glue will fall off on its own.
Diet
A nutritionist will discuss diet adjustments with you and your child that may be needed after a choleystectomy. A low fat diet is recommended for the first month after surgery. After that, you may slowly introduce fats back into your diet. Urgent diarrhea or abdominal pain after eating a high fat meal is normal and will decrease with time.
Medication
Your child may be discharged from the hospital with a pain prescription for moderate pain and a stool softener to prevent constipation from the pain medication. In addition, he/she can take ibuprofen (Motrin) or acetaminophen (Tylenol) for mild pain.
What are the long-term consequences of cholecystectomy?
There are no long-term effects on growth and development after a cholecystectomy.If the need for the cholecystectomy was due to some other chronic illness, that illness may have its own long-term effects.
What should I call the surgery team for?
- Redness around the incision(s)
- Drainage around the incision(s)
- Jaundice (yellowing of the skin or eyes)
- Fever, greater than 100.4 degrees Fahrenheit
- Persistent vomiting
- Pain that is not relieved by pain medication.
Follow up with surgery team:
A follow-up appointment should be scheduled for 2-3 weeks after surgery. Please refer to your discharge instructions for the phone number to call to make an appointment.
