John Ashcroft's non-vital organ.

John Ashcroft's non-vital organ.

John Ashcroft's non-vital organ.

Answers to your questions about the news.
March 9 2004 4:56 PM

The Gall of John Ashcroft

How he'll live without a non-vital organ.

Ashcroft: His bile has nowhere to go
Ashcroft: His bile has nowhere to go

Last Thursday, Attorney General John Ashcroft paid a late-night visit to George Washington University Hospital's emergency room, complaining of terrible stomach pains. Today, doctors removed his gallbladder in a two-hour procedure. What are the consequences of living without a gallbladder?

Though the gallbladder isn't quite as inconsequential as the appendix, the lingering effects of the organ's removal are surprisingly few. The gallbladder is a tiny pouch that stores the bile produced by the liver. When you eat a fatty meal, the gallbladder oozes some of that bile into the small intestine, where it helps break down the incoming food. The more fat in the meal, the more bile gets released.

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Once the gallbladder is gone, there's nowhere for that bile to collect. Instead, it trickles directly from the liver to the small intestine, and the amount can't be modulated to accommodate for a meal's fat level. That can be a problem should a person sans gallbladder try to chow some buffalo wings, or even something less sinful, especially in the weeks immediately following surgery. Without sufficient bile to break down the fat, the small intestine can become flooded with water—the fat draws it in from the surrounding regions of the body. That, combined with the fat-digesting activities of intestinal bacteria, can cause what polite people refer to as "digestive distress"—bloating, bad restroom experiences, and stomachaches. Though this condition is relatively common as the patient recuperates, the body tends to adapt to the gallbladder's absence over time. After a few months, Ashcroft should be able to resume more or less regular eating habits, though it's likely that his doctor will still recommend caution with deep-fried goodies.

The other big concern is perforation of the bile ducts or intestines during surgery. Ashcroft underwent a procedure known as a laparoscopic cholecystectomy, in which a slender probe is inserted into the abdomen via a small "keyhole" incision. This is a much less invasive procedure than the traditional laparotomy, which is a wide incision. The laparoscopic technique is favored among surgeons as safer overall, but inadvertent perforations do occur. In a worst-case scenario, bile can wash into the abdomen and cause life-threatening infections. Fortunately for Ashcroft, this particular complication is very rare.