From the Research
Gallbladder removal (cholecystectomy) generally has manageable effects on patients, with most people adapting well after surgery and experiencing minimal long-term consequences. The effects of gallbladder removal on a patient can be significant, but they are often temporary and manageable. Initially, patients may experience diarrhea, bloating, and digestive discomfort as the body adjusts to bile flowing directly from the liver to the small intestine rather than being stored and concentrated in the gallbladder. These symptoms typically improve within a few weeks but may persist longer in some individuals 1.
Key Considerations
- Dietary modifications can help manage these symptoms, including eating smaller, more frequent meals, limiting fatty foods, and gradually reintroducing fats to determine tolerance.
- Some patients may benefit from bile acid sequestrants like cholestyramine (4g taken before meals) if diarrhea persists beyond a few months.
- Without a gallbladder, bile flows continuously into the digestive system rather than being released in concentrated amounts during meals, which can affect fat digestion initially but the body typically compensates over time.
- Most patients can eventually return to a normal diet, though some may need to permanently limit fatty foods to prevent digestive discomfort.
- Rarely, some patients develop post-cholecystectomy syndrome with ongoing pain and digestive issues that require further medical evaluation.
Recent Evidence
A study from 2016 found that the management of gallstones in morbidly obese patients should not be different from normal-weight patients, and that performing a laparoscopic cholecystectomy only in symptomatic patients is an effective approach 1. Another study from 2006 found that ursodeoxycholic acid (UDCA) exerts no beneficial effect in patients with symptomatic gallstones awaiting cholecystectomy, and that early cholecystectomy is warranted in patients with symptomatic gallstones 2.
Recommendations
Based on the most recent and highest quality evidence, patients undergoing gallbladder removal should be advised to make dietary modifications to manage symptoms, and should be monitored for potential complications. Patients with symptomatic gallstones should undergo early cholecystectomy, as delayed surgery is associated with longer total hospital stay and convalescence due to recurrent cholecystitis episodes 3.