If your child's gallstones don't cause symptoms, treatment may not be needed. If they do, your child will need surgery to remove the gallbladder. This surgery is called cholecystectomy (pronounced co la sis TEC toe me).
It's OK not to have a gallbladder. If your child doesn't have a gallbladder, the bile will simply flow from the liver directly into the intestine. Your child should be able to eat normally and continue with normal activities after having the gallbladder removed. The most common symptom after removing the gallbladder is loose stool, especially after eating a fatty meal. Most children do not have this problem.
At the time of surgery, we will give your child medicine to make them sleep without pain during the operation (general anesthesia).
In most cases, surgeons can remove the gallbladder using laparoscopic surgery, also called minimally invasive surgery. This means they make several small cuts (incisions) in the belly instead of one large incision (open surgery). Surgeons insert a thin, lighted tube with a camera and their surgical instruments through these small incisions. Then they snip the gallbladder free and remove it through one of the openings.
The advantage of laparoscopic surgery is that surgeons don't have to cut through the stomach muscles. Children recover faster.
On rare occasions, children need to have open surgery instead of laparoscopic surgery. This may be the case if your child has had other abdominal operations in the past. If so, your child's surgeon will discuss it with you.
During the gallbladder removal operation, the surgeon may perform a cholangiogram, a study of the bile ducts. This study is not always necessary, but it helps doctors make sure that gallstones have not fallen out of the gallbladder and into the main bile duct. If the study does show gallstones in the main bile duct, the surgeon will try to remove them. Because the bile ducts of children are usually very small, this can be very difficult to do using laparascopic techniques.
In some cases, a child may need an ERCP (endoscopic retrograde cholangiopancreatography) to remove gallstones that have fallen out of the gallbladder. In an ERCP, the surgeon passes a lighted scope through the child's mouth, past the stomach and into the upper small intestine (duodenum). This way, the doctor can see the bile duct entering the intestine. Small instruments can be passed through the scope and used to remove the gallstones. An ERCP often helps doctors avoid doing a larger operation on your child. If your child needs an ERCP, it most likely will be done on a different day from the gallbladder removal surgery.
Removing the gallbladder takes about one to two hours. Your child will be in the recovery room for another hour.
After Gallstone Surgery
After laparoscopic surgery, you can expect your child to stay in the hospital for one to two days. Once your child is home, you may need to limit activity for several days.
After open surgery, you can expect your child to stay in the hospital for two to seven days. You may need to limit your child's activity for several weeks while they recover.
In either case, we will give your child pain medicine to make them comfortable. You'll need to keep the incisions clean and dry until they heal. The surgery team will teach you how to do this and tell you about any activity limits.
About two to three weeks after surgery, your child will need to see the surgeon for a follow-up visit. The surgeon will make sure the incision is healing and your child is recovering well.