A decade ago, surgeons developed a new way to remove a gallbladder that has formed painful stones. That technique, called laparoscopy, uses miniature instruments and a lighted tube equipped with a video camera, all inserted through tiny abdominal incisions. Laparoscopy has almost completely replaced traditional “open” gallbladder surgery, since the new approach causes less postoperative pain and permits quicker recovery. But since the advent of laparoscopy, the number of gallbladder operations has risen 40 percent. And a study of some 54,000 gallbladder surgeries in Pennsylvania found that the number of procedures done in patients with minimal or no symptoms has risen more than 50 percent. Apparently, the advantages of the new technique have convinced some doctors to try preventing severe attacks before they occur.
Some 10 percent of Americans have gallstones, and most of those people never develop significant symptoms. While laparoscopy is generally less traumatic than the old approach, it’s still major surgery with major potential risks. In fact, accidental severing of the bile duct, which can cause permanent liver damage, occurs in 1 to 2 percent of laparoscopies—three times more often than in open surgery.
Avoid gallbladder surgery unless you’ve had at least one severe attack or several less painful attacks in the upper right part of the abdomen, or if you develop jaundice or pancreatic inflammation—and tests confirm that stones are the real culprit. Surgery should not be done to treat vague symptoms such as flatulence or bloating, which many people—and some doctors—mistakenly attribute to gallstones. If you do need surgery, look for an experienced surgeon who has done at least 30 of the operations.
Needless Surgery. Reprinted from Consumer Reports on Health (March 1998)
© 1998 Consumers Union