What is Gallstone disease?
How it presents and what is the treatment?
What is gall bladder and what are its functions?
Gallbladder is an organ located on the undersurface of liver. It helps in the storage of bile that is secreted from the liver. Bile is a juice which contains various salts, pigments, etc and is essential for digestion. Presence of stones in the gall bladder is called Cholelithiasis (“Chole” means “bile”, “lithia” means “stone” and “sis” means “ process”)
What are the causes for gallstone formation? Who are the high risk group?
a. Inherited body chemistry
b. High Cholesterol diet
c. Hormonal imbalance particularly estrogen imbalance
d. Reduced motility and emptying of bile / stasis in gallbladder
e. Obesity
f. Lack of a pigment called melatonin
The high risk group for gall bladder stones is “fat”, “fertile”, “female” of “forty years”
But gallstones can occur at any age. No age / gender are an exception. The stones can occur any where in the gallbladder or biliary tract (the tract where the bile flows from the liver to the intestine) or liver.
What are the symptoms of gallstone disease?
Upper abdominal pain which vary from mild pain to severe pain. Nausea and vomiting. Jaundice – Displaced stones from the gallbladder can sometimes cause jaundice
How to diagnose gall stones?
Diagnosis of gallbladder stones is very simple procedure. Abdominal ultrasonography is a simple procedure which can pick up the presence of stones in the gallbladder.
What is the treatment for gallbladder stones?
Medical treatment with UDCA (Ursodeoxycholic acid) has been tried. But it helps in selected cases and requires long-term treatment without much successful outcome
The best treatment for gallstones is surgery. The gall bladder along with the stones is removed. The gallbladder can be removed by 2 methods.
1. Open surgery
2. Laparoscopic surgery
Fig. 2: Gallbladder removed after surgery with the stones
Gallbladder is routinely removed by Laparoscopic surgery. In the modern era, open surgery is rarely required to remove the gallbladder. Open surgery is followed only in difficult cases.
What is Laparoscopic surgery and what are its advantages?
Laparoscopic surgery is a procedure by which multiple small holes are made in the abdomen and the gallbladder is mobilized and removed through one of the holes. The entire surgical procedure takes 30 mins to 90 mins. Patient can go home after 24 hrs of operation.
Shorter hospital stay Less painful procedure Early post-operative recovery Cost effective surgery
What is single port surgery? (SILS–Single incision laparoscopic surgery)
In Laparoscopic surgery, instead of making 4 small holes, the gallbladder can be removed by a single hole. This is a new technique, less frequently practiced due to lack of adequate evidence to support this technique.
How safe this laparoscopic removal of gallbladder?
It should be performed by surgeons who have adequate training and experience in laparoscopic surgery. It is a safe surgery in the experienced hands.
What are the complications of gall bladder stone disease?
Gallbladder should be removed in all patients with symptoms due to stone disease. The gallstones can cause severe recurrent pain or jaundice due to obstruction of bile flow which may require an emergency procedure. So when performed in a nonemergency situation, the procedure is more safe compared to emergency situation.
Which group of people should be screed for gallstones disease?
Patients with recurrent upper abdominal pain Obese people Patients with symptoms of acidity or reflux of food contents middle aged fatty females with any abdominal symptoms
Is there any harm if the gallbladder is removed from the body for a stone disease?
There is no harm if the gallbladder is removed from the body for a stone disease.
What is the cost of surgery?
This surgery is not very expensive and easily affordable by a common man.
The medical information was provided by Dr.Dilip Chakravarthy, Sagar Hospitals, bangalore