Gallbladder removal during VSG surgery?

[ouroborous 519]

Hello, one quick question: I was under the impression that a gallbladder removal could happen during the same surgery as the VSG. In fact, I vaguely recall my surgeon mentioning that he wanted to do this because it was safer.

However, the surgical center staff now claims that it can't be done during the same op. I'm not sure if this is an administrative issue or a surgical limitation.

[Tiffykins 673]

My surgeon opts to not remove the gb at the same time. His reasoning is because during the rapid weight loss phase, being in ketosis, taking in extra fat especially from Protein foods the gb actually helps digest these foods completely. Plus, only 1/4 of his patients between VSG, band and RNY need to have their gb removed due to weight changes.

I tell you based on my experience. My gb came out 9 months post-op. I've had a hell of a time eating post-op and trying to maintain my weight. food that I ate just 2 months ago no longer work for me. I can eat them, but I'm in the bathroom shortly thereafter. It isn't pleasant, and I since I eat many foods still today that I ate during my losing stage, I would have very limited on what I could have eaten. If I happen to find myself constipated, a nice dollop of Ranch or Thousand Island dressing with about 4 crackers or a small spinach salad lands me in the bathroom for a solid 30 minutes. Constipation cured, butt burn in full effect. Probably TMI, but it's been my experience.

There is also a drug called Actigall that some surgeons prescribe. I declined due our livers working overtime during the rapid weight loss phase, I wasn't willing to add another RX to the mix to make my liver work even harder. Plus, there are some liver contraindications with Actigall. For me, the risk of keeping my gb were minimal considering all the factors presented to me.

[ouroborous 519]

Well I don't know for sure that I need my gallbladder out. I'm going in for my EGD on Thursday morning, and they'll know better what my innards look like at that point.

I hope I don't need it out, but we'll see...

[Lee 19]

Mine came out in November, Sleeve in February. My surgeon would not have done them at the same time. He just felt that's better to keep them separate. That said, he did find a hiatal hernia and repaired that when he did my Sleeve.

[pnw218 14]

I sent you a private message with more info; the short part is below ....

After having a gall bladder attack on a cruise ship, I had my gall bladder removed in November 2006.

The way I understand it is after having your gall bladder removed, the bile in your system is no longer controlled and many people start seeing digestion issues. They often are food in, food out. It is not nice at all.

After several months, I was able to get into a specialist who suggested Cholestyramine. It is a powder that can be mixed into juice or Water. That worked for several years. This past year, my dr switched me to Welchol which is a much easier med to take. It is a tablet and doesn't have to be scheduled around meals and other meds like the powder.

The bonus about Cholestyramine is that it also helps to maintain your cholesterol. I had never had any issues with cholesterol before having my gall bladder out. Now, after being on Welchol for 6 months or so, my cholesterol is a little elevated. My doctor believes that it will go down since I am losing weight and eating better. She will recheck it three months post op when she does my other labs.

Also - since having the VSG surgery, I have been able to quit taking the Welchol. Any issues I had with bile have resolved themselves.

[ouroborous 519]

pnw, I got your message and I think my response got lost in the aether -- sorry about that!

Long story short, I'm leaning towards a "wait and see" attitude. I don't want the pain of gallbladder removal, and I know I have decent odds of NEEDING it removed. But it's not a zero-cost equation, as you've pointed out. I really don't want to need a whole OTHER medicine (with possible side effects and complications) for my whole life if I don't HAVE to.

If the doc says I have to get my gall bladder out, I'll get it out. But I don't think I'm going to do it until that point.

Thanks so much for the advice (to all of you)!

[Lee 19]

When I had my GB out, the surgeon told me to eat low fat for life. I had the runs for a couple of weeks, then everything was fine. I think that we're all different.

[ouroborous 519]

Well, I had my EGD today and there were no signs of bile duct issues (and no hiatal hernia, duodenal ulcer, or esophageal erosion from GERD -- yay!). Just to be sure, since my mom's had gallstones, we also did an ultrasound on the gallbladder (and liver, and pancreas). If those come back clean, my gallbladder is in good health (for now) and I don't need it out. Here's hoping I can keep one more organ of my body intact and healthy!

[pnw218 14]

Well, I had my EGD today and there were no signs of bile duct issues (and no hiatal hernia, duodenal ulcer, or esophageal erosion from GERD -- yay!). Just to be sure, since my mom's had gallstones, we also did an ultrasound on the gallbladder (and liver, and pancreas). If those come back clean, my gallbladder is in good health (for now) and I don't need it out. Here's hoping I can keep one more organ of my body intact and healthy!

LOL about keeping one more organ! it might make the scale a little lower without?? :001_smile:

I have met lots of people who have had their gb out. Like Lee, some adjust or never have problems to start with. I am not sure why I am doing better and able to quit the meds since vsg, just glad that I am : )

[Dr. Jossart 2]

If there are reasons to remove the gallbladder such as stones, then it is certainly reasonable to remove it.

[TexasT 99]

If you do end up needing your gall bladder out, don't worry. I had a revision from band to sleeve, gall bladder removal, hiatial hernia repair, and adhesion removal done all at the same time. I'm all for "one stop shopping" if you know what I mean. I've got an amazing surgeon so I never worried about my "laundry list" of needs. My only issue post-op is that I can't eat ice cream any more without getting nauseated. Not sure if that has to do with the sleeve or no gall bladder. Either way, I consider it a good thing and have had no other issues.

[ouroborous 519]

Thanks for the replies. The followup from my EGD is that it looks like I won't need to have ANYTHING done aside from the sleeve itself (which, on a virgin stomach, should be a breeze). As long as I can follow the pre-op diet rigorously and shrink my fatty liver, the odds are that I should be in good shape!