I had an oesophagectomy in Feb 2012. I was diagnosed with Gall stones last Thursday and will be having an operation to have my gallbladder removed in 2/3 weeks time. i was wondering if anyone has had a similar operation and can offer any advice ir recommend the best person to talk to. I thought my cancer nurse would be a good starting point as the Consultant was not very forthcoming re the removal and i have little faith in GPs. My main concern is the bile/acid reflux and how this will affect me after having the oesophagectomy. I have had a look on t'internet but don't believe everything on there to be accurate. A low fat diet is recommended in particular a Mediterranean Diet, the bile still seems to pass into the intestine ok but I've read elsewhere there is an increase chance of colon cancer! Any advice welcome - thanks, Stuart
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Stuart2012
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Having had an oesophagectomy your digestive system is significantly different from average, as you know only too well! Your original surgery may have had an effect on the normal positioning of these organs in relation to each other.
The gall bladder acts as a reservoir of bile that helps with digesting fats
If you have too much bile, or are not digesting fatty food, then this needs to ba addressed one way or another. It is feasible that if you have trouble with bile reflux at the moment, removal of the gall bladder might help, but it is only the surgeon who can tell you this. Will it be the same surgeon as did your oesophagectomy? People often come up with questions after they have left the consulting room, so you are not alone in having these questions in your mind. Write them down and ask them so that you can have your mind put at rest.
If the surgeon has recommended removing your gall bladder then this will surely be based on good medical judgement. The diet and eating pattern that you have to have because of your oesophagectomy will always be a high priority. If you have access to a specialist Upper GI dietician, ask her for advice.
I personally have not heard of any increased chance of colon cancer because of this. Statistics are based on general population figures; and how it might affect an individual is an entirely different matter. It will not do you any good to have a gall bladder problem left unresolved, and the risks to your health and well being of not doing anything to resolve it will probably be far greater than any increased chance of colon cancer. But if it bothers you, than put the question to your surgeon, because they will be able to put things into context in a way that is relevant to you far more helpfully than what you may have read on the internet (including this posting by the way!).
You may have to remind them about and/or discuss how you will be positioned for the operation (ie lying flat may cause problems but they should be able to manage this OK; but it never harms to remind them).
I will seek further advice and come back to you, but this is really a matter of clinical judgement, and how the pros and cons for your particular condition are communicated.
Sometimes the surgeons are working out specialised technicalities in their own minds whilst discussing things with you, but I am sure that things could be made clearer for you if you ask.
in reply to
I am just adding that the surgeon I asked about this said that it would be difficult to say anything without seeing the patient and knowing the individual history, but the cancer risk is small.
I think that you probably need to discuss things further with your surgeon. Make a list of the issues that you are concerned about so that you do not forget. There is a well recognised procedure in the NHS for asking for a second opinion which most surgeons regard as a constructive and useful discipline. At the end of the day it is your condition that needs sorting out and in an ideal world you should have complete confidence in the relationship.
Thank you for the advice Alan. It is a different consultant and hospital to where I had my oesphogectomy. Had no date through but will hopefully get the opportunity to discuss it prior to the operation.
I have had these procedures and if my experiences are anything to go by then you should avoid it if there is any doubt about the need ,or any alternative.
I have had cholecystectomy (gall bladder removal) but I haven't had an oesophagectomy so my experience may not be the same but I have noticed no real difference since the operation except I probably defecate more often.
If you want a mildly amusing read (sorry, it is long), I did write a full account of my hospital experience when I had that operation: sites.google.com/site/robic...
I had an oesophagectomy in March 2007 and needed a gall bladder removel op in October 2008. When I was told I had Gall Stones I was due a routine visit to my consultant who agreed to do the operation. I have been fine ever since. I still get the odd "acid attack" but it is usually when I have eaten to much fatty food. Take it easy after the op as you will be quite sore, don't lift things and you will soon recover
Following up my short post of yesterday- there are some questions which should be posed:
1)At the time of your Oesophagectomy the surgeon would have made an extensive examination of the entire contents of your intestinal cavity, primarily seeking signs of Metastasis (spread of cancer secondaries).It seems questionable that Gallstones have been manifest only in the last 12 months.
There are those who might suggest that overlooking such an important symptom in 2012 may amount to negligence.
All surgery caries risk and Cholecystectomy is a life changing procedure.
Following major abdominal surgery such as Oesophagectomy all patients are left with adhesions, where the organs, membranes etc. etc. literally stick together; the normal mechanisms of lubrication and sliding over one another having failed. This makes any subsequent additional surgery more difficult – the practitioner has to ' hack a way through the jungle of scar-like tissue '.
What type of surgery have you been offered- open or laparoscopic?
It was for this very reason -to avoid having to go in there again-that my surgeon removed my perfectly healthy Gallbladder during my Oesophagectomy.
BUT
Since the mid-eighties medical text books have reported that up to 30 per cent of Cholecystectomy patients experience post-op Diarrhoea which may be chronic and persist for years. This is not trivial given that there will be concomitant problems of de-hydration and electrolyte imbalance with Calcium loss, Vitamin deficiency, depletion of bone integrity and so on.
In my own case I was incontinent of faeces for 16 years, house-bound and suffered two fractures of the Spine; before eventually discovering a palliative medicine(Cholestyramine).
A further complication is that you will have to juggle the to some extent competing dietary requirements of both conditions. Life without a Stomach is bad enough.
Have you been ruled out for other non-surgical treatment such as Drug Dissolution or Lithotripsy?
If not I urge you to explore these possibilities with your specialists and if they are uncooperative then ask for a referral elsewhere.
I had my gall bladder removed prior to my oesophagectomy as part of a liver resection to ensure my liver was clear prior to the main event (a long story!).
I didn't question it at the time as I was focussed solely on having the oesophagectomy. Since then (over 2 years) my experience has been similar to others on here including the vast range of digestive issues and unpleasantries.
I had to have it done, otherwise no oesophagectomy which would have been totally unacceptable to me.
I would have questioned the procedure in far more detail had the running order of operations been reversed - I was just grateful for the chance to have my tumor removed.
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