Gallbladder Surgery?

[Shante424]

I have had a couple of bouts of gallbladder pain, about one year apart. Except for 1-2 days of bad pain, it has been more general soreness or tenderness to the touch for up to several weeks at a time. Two sonograms at different times revealed no stones. A HIDA scan gave an ejection fraction of 31%. A few months prior to the onset of the first attack, I had a bad case of food poisoning.

My questions are:

Could this acalculous, seemingly chronic, low-grade inflammation, with occasional flare-ups, be a result of damage or scarring from the food poisoning incident?

I have no stones and am not in pain very often. I am, however, having some other digestive problems (bloating, reflux, gas, etc.). Given that some of these might result from the gallbladder's inability to efficiently secrete bile when needed, how would surgery (which the doctor has recommended) help with this problem? Wouldn't a partially functioning gallbladder be better than no gallbladder at all when digesting fats?

I would like to get pregnant in the next 12 months. If I delay the surgery, am I putting my pregnancy or fetus at risk if the additional estrogens circulating in pregnancy cause an acute gallbladder attack necessitating surgery at that time? Is this an unlikely scenario?

Can you give me a reference for any information on the risks of malignancy developing in an inflamed gallbladder left intact?

Thank you for your consideration

[Kevin Pho, MD]

To answer your questions:
1) A gallbladder ejection fraction of 31% is borderline.  Acalculous gallbladder pain is possible, and if suspected, removing the gallbladder can be considered.

2) Removing the gallbladder should not have any long term digestive problems.  There are some cases of diarrhea after surgery, but the majority of patients are without long-term effects post procedure.

3) If there are no stones, the chances of a gallbladder attack are less likely.  However, there is no guarantee that you will be symptom free during this period.

4) I am not aware of a low gallbladder ejection fraction being associated with cancer.  

Another possibility that you may want to pursue would be an evaluation of biliary duct stones.  This can be examined with an MRCP.

These questions can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[emlynn74]

I just had my gallbladder removed about three months ago. I feel so much better and haven't gotten sick at all since then.
I say call you doctor and tell him/her you want it out ASAP.
Good luck and good luck with the soon to come baby!!!

[britt8907]

For gallbladder pain and pregnancy, I only know about what my mother told me. She had hers removed a month after pregnancy because of the hormones helping trigger the attacks, and had she not gone to the doctor, a week later it could have been a really big problem seeing as most of her pain was thought to be from the pregnancy itself.

I must point out that I'm not 100% how accurate that is, despite my doctor questioning me seeing as I had to have my gallbladder removed just over a month ago, and I'm only 18 (but so was my mother at the time). Mine, however, was not influenced by pregnancy, but regardless, depending on the pain and the overall situation of the problem, is what should be looked at for removal. Just keep in mind that pregnancy can trigger problems with the gallbladder sometimes.

[beyer]

I had a cck test and it showed my ejection fraction at 2% the doctor said he never seen a ejection fraction that low.  I am in pain everyday and I take promethazine for the nausea, if I don't take it I would be vomiting all the time. What would cause such a low ejection fraction? Why did I not have pain before it became so low?