Medical Questions & Answers

Question: I had a laparoscopic gall bladder removal four years ago, but still have discomfort in the area, particularly after a large meal. Is this normal?
Laparoscopic removal of the gall bladder involves cutting three or four one-centimeter long holes in the abdomen, and inserting tubes through these holes, which are used for the surgeon to see what he or she is doing and the passage of instruments to perform the operation. Recovery is usually far faster than the open operation in which a 12 to 15 cm cut is necessary.
With any operation there is some scarring, and it may be that scar tissue has formed around the site of the gall bladder which is pinching nerves or adhering to surrounding structures. This is the most common cause of post-operative pain. It may be that the cause of your pain is due to some other disease process in the liver, stomach, intestine, pancreas or overlying muscles, and totally unrelated to your surgery.
Rarely, a gallstone may be left behind in the bile duct, and may be responsible for continuing post-operative discomfort. In all cases you should return to your doctor so that a further examination and investigations can be performed to determine the exact cause of your problem.

Question: Ten weeks ago I had my gall bladder removed by laparoscopy. f was discharged after three days, but since then I have had discomfort under the right rib cage and in the shoulder blade. Is this pain normal?
Laparoscopic surgery is marvelous innovation that enables medium level surgery, such as removing the gall bladder, to be performed through tiny holes using long thin tubes to look into the belly and operate through.
The main advantages are far less pain from the incision, and being able to leave hospital in a very short time.
During the operation, the belly is blown up with gas in order to separate the organs from each other and enable the surgeon to see what he or she is doing. At the end of the operation, every attempt is made to remove this gas, but it is impossible to remove all of it.
As you recover, the remaining gas is slowly absorbed into the bloodstream, but this may take some weeks.
One of the places the gas tends to accumulate is above the liver, and under the diaphragm, behind the ribs on your right side. Here it can cause some irritation and discomfort. The nerves that supply the diaphragm run down from the shoulder, so it is not unusual to experience referred pain in the shoulder from the gas under the diaphragm.
All your symptoms should settle gradually in the three months after the operation, and there is no cause for concern unless the pain worsens.

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