GallStones and Gallbladder Removal

Gallbladder is the small pear-shaped sac-like organ present under the liver that collects the bile (digestive juice) manufactured by the liver. This bile is then released from the gall bladder as and when required which helps in breakdown of the dietary fats thus assisting in digestion.

Gallbladder stones are the most common problem of the digestive system and affect a large percentage of the population. Around 15% of the people above the age 50 years are known to suffer from gallbladder stones. More common in females and overweight individuals, gallstones are the small biliary calculi that are formed by cholesterol, bile pigments or calcium salts. Gallstones are formed when there is excessive cholesterol in the bile, the crystallization of which results in incomplete emptying of the gallbladder.

Most often, gallstones do not cause any symptoms and go unnoticed. However, if they do, the common symptoms include:

• Jaundice
• Severe abdominal and back pain
• Fever, vomiting, indigestion
• Abdominal pain usually after eating fatty meals

However, complications like blocking of the duct due to large stones, infections or pancreatitis may need quick treatment and surgery.

Gall bladder stones are easy to diagnose. The doctor may look for jaundice and get the blood tests done. Ultrasound is a convenient and quick way to get the gallstones detected. There are other complicated tests like ERCP if the doctor suspects stones in the bile duct.

Causes of Gallstones:

The exact cause of developing gallstones is uncertain. However, gallstones may be formed due to one of the following reasons:

• Alterations in the bile components
• Failure of the gallbladder to empty completely
• Excessive production of cholesterol in the liver which results in cholesterol crystals formation that ultimately grows into gallstones.

Gall Bladder Removal Surgery (Cholecystectomy)

A cholecystectomy is a surgical surgery that removes your gallbladder. A cholecystectomy is a fairly common procedure that has a low chance of complications. You can usually return home the same day as your cholecystectomy.

The procedure can be done either through open surgery or laparoscopically.

During laparoscopic cholecystectomy, a tiny video camera and special surgical equipment are inserted through four small incisions into your belly to see into your abdomen and remove the gallbladder.

In some circumstances, the gallbladder can be removed by a single big incision. The procedure is known as an open cholecystectomy.

When is Cholecystectomy needed?

If you are diagnosed with gallstones and suffering from severe pain, if the size of the stones is more than 1 cm, or if your gallbladder is inflamed causing cholecystitis and is impairing your day to day life, you may require surgical intervention to remove the gallbladder (cholecystectomy).

Your doctor may also recommend a cholecystectomy (gallbladder removal) if you have:

1. Gallstones in the bile duct (choledocholithiasis)
2. Gallbladder inflammation (cholecystitis)
3. Large gallbladder polyps
4. Pancreas inflammation (pancreatitis) due to gallstones

Gallstones Treatment Options

The gallstones can be symptomatic or asymptomatic. Asymptomatic gallstones, or the gallstones which do not cause any symptoms, do not need any medical intervention. But the surgeons would advise you to remove the gallbladder if you are prone to develop complications of gallstones.

Following are the treatment options that highly depend on the size and site of the stones:

1. Medication: It is rarely advised in treatment mode, in which medicines are given to dissolve the stones. It has side effects and low success rates.
2. Dietary modifications:This includes reducing and excluding the intake of fatty foods and dairy products which can help prevent the symptoms.
3. Lithotripsy: This is done in a small number of cases in which the patients have small and soft stones. The sound waves produced by the lithotripsy machine are used to break the gall stones, which are then either removed through intervention or are excreted out of the body naturally.
4. Surgical intervention: This is the most widely adopted intervention in which either the entire gallbladder or only the gall stones from the bile duct are removed using different techniques. A gall bladder is not a vital organ, so one can manage and live a normal life without having it. The surgery is medically known as cholecystectomy.

The surgical interventions for removal of gallbladder include:

• Laparoscopic Cholecystectomy: This the minimally invasive surgery (keyhole surgery) in which the surgeon makes small incision on the skin and with the help of guided camera, gall bladder is located and using the specialized surgical tool, gallbladder is removed through one of the incisions.
• Open surgery: It is commonly referred to as laparotomy. Open surgery is indicated in individuals who already have undergone previous abdominal surgery or who have bleeding disorder. In this, the gallbladder is removed by making wider incisions in the abdomen, through which the gallbladder is removed.