Gallbladder surgery :Tips on post-operative care and diet

Gallbladder Stones: Simple Regime, Fast Recovery

An abdomen pain shooting up towards the back, pain experienced during urination are all signs that it is time to get an ultrasound done. Gallbladder stones have become more prevalent than ever before. According to Dr (Maj Gen) AK Sharma, women are more prone (61%) to this health issue than men (39%).

In 2011, gallbladder removal was 8^th most common surgery happening in the US. Most studies show that it is a lifestyle disease. Lack of physical activity and an individual’s diet are the primary factors for the formation of gallstones. Gallbladder stones are mainly formed of cholesterol which makes it obvious that a lot of unsaturated fat intake in food can lead to such problems.

Gallbladder Removal

Gallstones can vary in size from tiny as a grain of sand to the size on a Table tennis ball. Usually, patients with very small stones or potential threat of getting gallstones go through Cholecystectomy. Depending on the severity of the condition, patients are advised to undergo this Laparoscopic surgery or very rarely they are asked to take medicines that dissolve the gallstones and they are released with urination.

Patients who are diagnosed with large gallstones are often advised not to undergo Laparoscopic Cholecystectomy in fear of developing cancer. In such cases, an open gallbladder removal surgery is performed. Individuals who have a chronic and recurring problem despite surgical removal of stones are often advised to go through an open gallbladder operation.

Though both the laparoscopic (keyhole) and open gallbladder surgeries are performed under general anesthesia there remains room for complications no matter how rare or small.

• Bile Leakage: During the surgery, the tube that connects the gallbladder to the bile duct is clipped and sealed. In case the seal breaks or if the clips are loose, bile might leak into the abdomen area causing severe pain, nausea, fever and swelling in the abdomen. Usually, a bile leakage can be fixed without further surgery but in a few cases, the thing can go more complicated.
• Bile Duct injury: The whole idea of the surgery is to make sure that the bile from the bile duct does not reach the gallbladder because of which the surgical area is very close to the bile duct. At times while removing the gallbladder the bile duct can get injured which can cause further complications if not checked immediately.
• Risk of clotting: People with prior history of clotting or cancer patients might develop clots during the surgery. These clots develop in the legs and are released into the bloodstream. With the blood, such clots travel in all parts of the body and can reach the lungs or the heart seizing it from working.
• Post Surgery Infection: This is more likely to happen in the case of open gallbladder surgery. Any wound is prone to micro bacterial infections and may happen either internally or externally around the surgical incision. Such an infection might cause swelling in the surrounding areas with increased pain and chances of pus leaking from the wound.
• Excessive Bleeding: Though it’s a rare occurrence, some individuals might experience severe bleeding after the surgery. In some cases, additional surgery is needed to stop the bleeding.
• Pneumonia: Because the operations are performed under general anesthesia, patients are given a breathing tube which goes all the way to the windpipe. This can sometimes cause pneumonia or severe lung infection.

Usually, immediate recovery after gallbladder surgery is smooth. Patients are advised to stay in the hospital for a few days after the surgery but most patients who go through the keyhole surgery get discharged the same day of surgery. A few precautionary tips patients can follow like not taking a bath till the doctors say so and drinking a lot of fluids and water.

Post Operation Conditions

Removing one organ and not getting a transplant can be a scary thought. Most patients get apprehensive about the kind of life they will be able to lead post surgery. Pat F. Bass III, an associate professor of medicine and pediatrics at Louisiana State University Health Services Center, states that most animals in the world live without a gallbladder and it is not at all difficult for humans to live without one.

There will be changes; however, those are minuscule in front of getting a healthy life. Prof. Bass explains that the discomfort experienced due to the absence of gallbladder is nominal. It has some effect on the way the body digests food but no real changes are experienced by the patients. After the surgery some dietary restrictions should be followed:

Things you can eat:

Low-Fat Oils

After the removal of the gallbladder, there is no bile storage in our body which actually helps the small intestine in digesting food so to go easy on our digestive system it is advised that the patients stick to a low-fat diet for a few weeks after the surgery. The body takes a little bit of time to adjust to the change in the way food needs to be digested and adapt to the new way.

It is advisable to not take the usual refined oil for cooking and switch to a healthier option like olive oil, coconut oil or try to take flax seeds in your diet.

Steamed Veggies

Vegetables are good for health, however, steamed vegetables are better because they can bind themselves to bile acid easier. In absence of any storage of bile fluid to help with the digestion steamed vegetables like broccoli, cabbage, capsicum etc., can avoid any indigestion.

High Fiber Meals

High fiber foods are always suggested to people with chronic constipation or similar digestive problems. Food rich in soluble fibers is good for individuals recovering from gallbladder operation as it provides a catalyst for digestion. Food items like beans, lentils, sprouts and different edible seeds, barley and oats, fruits and vegetables, potato with skin, whole grain bread, nuts like almond and walnuts.

Eat Lean

Few of us have our favorite meats like red meat or pork but during the post-surgery phase, it is highly recommended that such meats are avoided and instead only certain lean meats are consumed. People who can’t stick just to a vegetarian diet can have chicken breasts, turkey, some sea fish like trout or salmon, freshwater fish etc.

Things to avoid

Dairy products

Raw or processed, dairy products are hard to digest and in case of a recovering digestive system, they should be avoided. Milk, cheese, condensed milk, powdered milk, full-fat yogurt, butter, ice cream, fresh cream, sour cream, whipped cream, mayonnaise are a few commonly used dairy product used in every household which should be strictly avoided during the initial phase of recovery.

Processed Foods

Processed foods or sweets and confectionaries usually have a lot of fat and preservatives which can torment the digestive system during its post-surgical adjustment phase. Things like cakes, pastries, cookies, instant noodles, processed meats, sugary cereals should be avoided for better recovery after gallbladder removal operation.

Caffeine and Alcohol

Caffeine and alcohol both produce extra acids in our stomach. After the gallbladder removal surgery, it is advised to avoid foods containing any of these or consume them directly. Coffee, tea, energy drinks, soda, chocolate, and coffee flavored food should not be taken before the body gets accustomed to the changes.

Some Additional Health Tips

• Right after the surgery, it is better to stick to a liquid diet for a few days. Solid foods can be included in the meals slowly starting with the lighter foods.
• For the initial few days, it is advised to only have vegetarian food after solid foods are included in the diet. Vegetables and fruits are easier to digest than any form of animal protein.
• Instead of taking heavy meals only a couple of times a day it is more prudent to have small meals multiple times a day. This will put less stress on the digestive system keeping it active but not tired.
• Self-monitoring proves helpful in the initial days to identify the food items that are causing any discomfort. It is advised to maintain a journal with a diet chart to do the same.

Gallbladder removal safe during Pregnancy

During pregnancy a lot of women are diagnosed with gallstones, however, most of them dissolve medicinally or post delivery. The formation of gallstones in pregnant women is mainly due to the hormonal changes they go through especially due to excessive progesterone. In some cases, however, they do need to go through Laparoscopic surgery. Due to excessive hormones the cholesterol levels in the bile in pregnant women increases which restricts the release of bile from the gallbladder. That leads to the formation of gallstones during pregnancy.

There is a lot of resistance against the idea of surgery on a pregnant woman. Many fear that any such surgery might affect the growth of not only the fetus but the infant as well. The reality is gallbladder stones can cause more harm to the fetus than the surgery ever can. Due to the formation of gallstones, it restricts contraction of the gallbladder which can

• make the infant pass stool prematurely before birth causing breathing problems
• induce premature birth
• cause still birth

Researchers have found out that if the surgery is done in the first or the second trimester the risk is next to nothing. According to available data, gallbladder removal surgery is the second most common amongst pregnant women. Most common being appendicitis.  The basic post surgery precautions are mostly the same for pregnant women with the same kind of dietary restrictions followed by someone who is not pregnant.

Not common in Dogs or other animals

As commonly heard in humans, Laparoscopic Cholecystectomy is not a surgery common amongst our beloved pets. The conditions in which this is performed are a little different in our canine friends. LC is performed in dogs when they have the condition called Gallbladder mucocele in which a lot of mucus gets accumulated into their gallbladder restricting the bile movement.

Though rarely found in dogs, 75% of times they need to be immediately admitted. Humans can still endure this condition before it becomes critical, dogs need to be treated immediately for gallbladder problems otherwise it can cause a rupture and inflammation.

Veterinarians usually use a lot of restraint before suggesting a surgical treatment for gallbladder problems in dogs. Usually, it is treated medicinally but in case there comes a fear of rupture due to over filling of the bladder it is advisable to go for the surgery.

It is an established fact that gallbladder problems are increasing and the main cause is our lifestyle. One way of avoiding such a dysfunction is to maintain a balanced diet and exercise regularly or be engaged in some form of sport. Instead of applying severe restrictions on yourself post surgery it is better to apply lighter dietary and lifestyle restrictions proactively.

References

• https://www.mayoclinic.org/tests-procedures/cholecystectomy/about/pac-20384818
• https://www.healthline.com/health/gallbladder-removal-open#preparation
• https://www.healthline.com/health/gallbladder-removal-side-effects#nonsurgical-options
• https://www.nhs.uk/conditions/gallbladder-removal/
• https://www.healthline.com/health/gallbladder-removal-diet#foods-to-eat
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699057/

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