Like any surgery, gallbladder removal comes with a risk of certain complications. These include both general risks associated with surgery, as well as potential changes to your digestion that are a unique risk of this procedure. While digestive changes after gallbladder removal may be alarming, they’re usually not an indication that anything is seriously wrong or that further treatment is needed. Dietary changes and time are usually the best way to manage any digestive symptoms. On the other hand, there’s a small risk of serious complications that require your doctor’s attention and possibly further medical or surgical intervention. It’s important to be on the lookout for signs of these complications. Here’s a list of both relatively benign digestive disturbances and more serious complications that may result from gallbladder removal.
Digestive Changes After Surgery
After your gallbladder is removed, your liver will still produce enough bile to help digest your food, but it won’t be stored in the same way, per the Cleveland Clinic. Without a gallbladder to store bile between meals, your small intestine will need to rely on your liver to produce more of the bile it needs in real time. While your liver will eventually adapt to this situation — and your bile ducts may enlarge to store more bile in the absence of a gallbladder — at first you may have difficulty digesting certain foods. High-fat and certain high-fiber foods tend to be the most difficult ones to digest in the days and weeks following gallbladder removal. As a result, you may experience these symptoms:
Abdominal pain after eatingBloatingGasDiarrhea
If these are the only symptoms you experience and they occur after meals, they can probably be explained as a normal postsurgical reaction rather than a worrisome complication. You’ll probably be able to reduce these symptoms by limiting fatty foods in your diet (fried foods, high-fat meat and dairy products, cooking oils), cutting back on certain irritating and gas-producing foods (whole grains, nuts, seeds, broccoli, cabbage, spicy foods), and eating smaller, more frequent meals. Usually your digestion will return to close to normal and you’ll be able to eat most foods again about a month after your surgery, according to the Cleveland Clinic.
Potential Complications of Surgery
In addition to the expected digestive side effects, gallbladder removal carries a small risk of various complications. These include:
Bile Leakage
As part of the surgery to remove your gallbladder, clips are used to seal the tube that connected the gallbladder to your main bile duct. It’s possible, though, for bile to leak into the abdomen if the clip doesn’t adequately seal the tube. When a bile leak occurs, symptoms may include abdominal pain, nausea, fever, and swelling of the abdomen, per the United Kingdom’s National Health Service (NHS). Sometimes a bile leak can be drained without the need for further surgery. In more severe cases, though, an operation is needed to drain the bile and wash out the inside of your abdomen.
Bile Duct Injury
In some cases, your main bile duct may be injured in the course of removing your gallbladder. During surgery, bile ducts may be cut, pinched, or burned, according to the Cleveland Clinic. This can lead to the leakage of bile into the abdomen or the blockage of bile flow from the liver. If your surgeon realizes this right away, it may be possible to fix the problem immediately. More severe bile duct injuries are often referred to medical centers with expert teams that can better deal with this problem.
Injury to Surrounding Structures
In extremely rare cases, your surgery may cause damage to nearby blood vessels, your liver, or your intestines, per the Mayo Clinic. These problems can usually be spotted and fixed right away, but if they’re noticed only later, another operation may be needed.
Colicky Pain
A study published in March 2018 in the journal HPB found that among people who underwent gallbladder removal because of mild gallstone pancreatitis (inflamed pancreas), nearly 15 percent experienced an attack of pain in the area after the surgery. Most of these attacks were single events that took place within two months of the surgery. No factors were found to predict who develops this type of pain. In some cases, pain may result from gallstones remaining in the bile ducts. Some people can form gallstones in their bile ducts even after gallbladder surgery, which can also cause pain. Surgically removing these gallstones may resolve the pain.
Postcholecystectomy Syndrome (PCS)
After gallbladder removal surgery, some people experience stomach pain, indigestion, diarrhea, and fever–symptoms mirroring those that cause gallstones. This is called postcholecystectomy syndrome (PCS) and is thought to be caused by bile leakage or remaining gallstones left in the bile ducts. However, sometimes the cause is not known. These symptoms tend to be mild and go away on their own, but if they persist talk to your doctor about possible treatments, including surgery to remove any remaining gallstones or medication to ease symptoms.
Blood Clots
People with certain risk factors — like prior clots, prolonged immobilization, or cancer — are at higher risk for developing a blood clot after surgery, according to the Centers for Disease Control and Prevention (CDC). This type of clot, known as deep vein thrombosis, usually develops in your leg but can travel to — and lodge in — other areas of your body, causing problems such as cutting off blood flow to parts of your lungs (known as pulmonary embolism). If you have an elevated risk for blood clots, talk to your doctor about ways to mitigate the risk. These may include getting up and walking around as soon as you are able to after surgery, wearing medical compression stockings, and taking blood thinning medication to prevent clots.
Infection
After your surgery, you may develop either an internal infection or one at the incision site. Signs of an infected wound include:
Increased pain at siteSwellingRednessPus leaking from wound
To treat an infection, your doctor will prescribe antibiotics. In rare cases, it may be necessary to surgically drain fluid or pus from the infected area.
Bleeding (Hemorrhage)
While it’s rare, bleeding can occur internally or externally after your operation. If this happens, you may need a further operation to stop the bleeding.
Anesthesia Reactions
It’s possible — though very rare — to have severe reactions to the anesthesia used for your surgery, including a severe allergic reaction or even sudden death.
Heart Problems
Especially if you already have cardiovascular disease, the stress of surgery can cause or worsen heart problems.
Pneumonia
During your surgery, you’ll be given a breathing tube, since you won’t be able to breathe on your own under general anesthesia. This ventilated breathing may increase your chance for pneumonia. In rare cases, you can develop a lung infection following your surgery as a result of this. Depending on its severity, you may be prescribed oral antibiotics, or you may need to be hospitalized and given intravenous (IV) fluids and antibiotics.
Scars and Numbness
It’s possible that you’ll develop scarring and a loss of sensation at or around your incision sites, according to Johns Hopkins Medicine.
Hernia
Part of your intestines or some other tissue may bulge through your abdominal wall at an incision site. This bulge may be painful, and if it doesn’t resolve on its own, it may require surgery to correct. Additional reporting by Ashley Welch.
