Does gallbladder removal have a big impact on the body? What is the most important thing after the operation?

Author: Yang Zhiying, Chief Physician of China-Japan Friendship Hospital

Reviewer: Shi Wenzai, attending physician at Peking University International Hospital

The gallbladder plays a major role in the human body:

First, it stores bile, which is its biggest function. It is a storage bag. After bile is secreted and discharged from the liver, it is stored in the gallbladder. We know that bile is used to digest food, especially the digestion of fatty foods, which requires bile to emulsify before they can be decomposed and absorbed. It is precisely because the gallbladder stores bile that when eating, it is stimulated by eating and will contract, and then discharge bile into the gastrointestinal tract to mix with food to digest food.

Second, it concentrates bile. The bile secreted by the liver is relatively thin. After being stored in the gallbladder, it is absorbed by the gallbladder wall and concentrated, making it more efficient when digesting food.

Figure 1 Original copyright image, no permission to reprint

However, when the gallbladder has certain lesions, such as gallbladder cancer, we have to remove it. So what are the effects of gallbladder removal on the human body? Is there a high risk of surgical treatment for gallbladder cancer? What is the most important thing after surgery? Let's find out together.

1. What effects will gallbladder removal have on the human body?

In fact, the impact of gallbladder removal on the human body is not very large. When the gallbladder is diseased, the harm of gallbladder removal to the human body is far less than the harm of the gallbladder disease itself to the human body.

However, after the gallbladder is removed, there is no place to store bile. Although the bile duct system can compensate for part of the gallbladder's storage function, this compensation is limited. When not eating, bile will continue to be discharged into the gastrointestinal tract, causing irritation to the gastrointestinal tract. After surgery, some patients will have some symptoms of reflux gastritis and reflux esophagitis, and sometimes have occasional stomach pain, heartburn, acid reflux, etc. This is the most common.

Figure 2 Original copyright image, no permission to reprint

Some people may ask, does the incidence of colon cancer increase after gallbladder removal? This is actually a statistical figure. We all know that the incidence of cancer in various organs of the human body is based on a base of 100,000, such as 5 in 100,000 or 8 in 100,000.

Let's assume that if the incidence of colon cancer in the normal population is 5 in 100,000, and the incidence in patients who have had their gallbladder removed rises to 8 in 100,000, then we can say that after the gallbladder is removed, the incidence has increased by 60%. But how much value do 5 in 100,000 and 8 in 100,000 have for each of us?

So this fear is actually unnecessary.

2. Are surgical treatments for gallbladder cancer risky?

For early stage gallbladder cancer, simply removing the gallbladder by laparoscopy or laparotomy is a very simple operation. For a normal adult, a normal gallbladder removal has low surgical risks and a quick recovery. The patient can be discharged from the hospital in about two or three days and can basically return to normal.

Unless the patient has some serious complications, such as heart, cerebrovascular, lung, kidney, etc., surgery is still very dangerous. Or for elderly patients, such as those in their 80s or 90s, this may be a very big surgery with high risks.

For patients with suspected local invasion of gallbladder cancer, when radical surgery is needed, the surgery is relatively large. In addition to removing the gallbladder, a part of the liver must be removed, and lymph nodes must be cleared at the same time. But in general, the safety of surgery for such patients is also very high, and generally no serious complications will occur, so you can rest assured.

The surgical risk is relatively high only when local invasion is obvious, such as involvement of blood vessels, involvement of the hepatic hilar bile duct, or involvement of surrounding organs, such as the colon and stomach, and combined organ resection is required. However, in the hands of experienced doctors, the safety of patients can be guaranteed, and the chance of serious complications is also very low, so there is no need to worry too much.

When a doctor evaluates whether a patient can undergo surgery, in addition to considering the patient's condition, he will also make his own judgment based on his ability. When he thinks the surgery is possible, he is usually very confident, so the risk of the surgery is controllable.

3. What is the most important thing for patients with gallbladder cancer after surgery?

The most important thing after gallbladder cancer surgery is regular check-ups.

Figure 3 Original copyright image, no permission to reprint

Usually in the first six months after the operation, you should go for a follow-up visit every month to check your liver function and tumor markers, and do an ultrasound to see if there are any abnormalities.

Six months after the operation, you should have an MRI and CT scan to see if there are any signs of recurrence.

After six months, check every two to three months.

After one year, another MRI, CT or other imaging examination should be done.

After one year, you should have a check-up every three to six months, and also have regular MRI and CT scans.

If it is a relatively advanced stage, i.e. stage III or IV gallbladder cancer, the high-risk period for recurrence is about half a year after surgery; however, most gallbladder cancers most often recur between one and two years after surgery. This period must be taken particularly seriously.

Of course, even if there is no recurrence or metastasis after two years, you cannot relax and need to have regular checkups, such as every three to six months. The outpatient doctor will give you corresponding diagnosis, treatment and maintenance suggestions based on the results of each checkup, and will also tell you when the next checkup is. It is very important to follow the doctor's advice and have regular checkups.