Ashcroft Recovering From Removal of Gallbladder

U.S. Atty. Gen. John Ashcroft had his gallbladder removed Tuesday in a 90-minute procedure that doctors pronounced successful, but which could keep him from his duties for at least another week or two.

Ashcroft, 61, was expected to remain at George Washington University Hospital for four or five more days, extending a stay that began Thursday, when he was admitted to intensive care.

After complaining of possible stomach flu, he was diagnosed with a severe case of gallstone pancreatitis, an abdominal condition that can be lethal.

The Justice Department declined to say when Ashcroft would return to work, but some medical experts said he probably wouldn’t feel completely well until a week or two after leaving the hospital.

On Monday the department canceled his appointments for the week, including an appearance before the House Appropriations Committee to discuss the Justice Department’s fiscal 2005 budget request.

Department regulations designate the deputy attorney general, James B. Comey Jr., to act on Ashcroft’s behalf in his absence.

At a hospital news conference, Ashcroft’s doctors said they expected he would make a full recovery.

They said he would have to avoid fatty foods to compensate for the loss of his gallbladder. The gallbladder stores and regulates the flow of bile, which helps digest fat.

Dr. Bruce Abell, Ashcroft’s surgeon, said the attorney general tolerated the laparoscopic procedure very well and was in guarded condition, being treated with painkillers and antibiotics.

“Long term, he should have a complete recovery,” Abell said.

Medical experts said the expected timing of Ashcroft’s release indicated that doctors thought he had turned the corner on the underlying pancreatic problem.

Removing the gallbladder is standard treatment for patients with his condition, which results when gallstones migrate and block an opening into the small intestine, causing the pancreas to become inflamed.

It is removed because of concern that other stones in the gallbladder will cause recurring blockages.

Abell said doctors detected several other gallstones, which form from the buildup of bile and other chemicals.

In the most severe cases, the pancreas starts producing enzymes that can attack other major organs in the body and even cause death.

In other cases, part of the pancreas can become diseased and its tissue can die, necessitating that a portion of the organ be removed.

Abell said doctors found no evidence of this condition, called necrosis, in Ashcroft’s case.

The laparoscopic procedure involves the insertion of a fiber-optic instrument through a small incision in the abdominal wall, which avoids conventional surgery and the need for larger incisions. In most cases, people who have gallbladders removed using the procedure are able to leave the hospital in a day, but Ashcroft’s case was complicated by the pancreatic disease.

“When he goes home, he will still want to take a week to hang out and recover,” said Jacques Van Dam, clinical chief of gastroenterology and director of endoscopy at Stanford University Medical Center.

“That is a minimum. It could be up to two weeks. It sounds like he had a very tough time.”