GALL STONES AND CHOLECYSTECTOMY
The Gallbladder
The gallbladder is a small, pouch-like organ found underneath the liver. Its main purpose is to store and concentrate bile.
Bile is a liquid produced by the liver to help digest fats. It’s passed from the liver into the gallbladder through a series of channels known as bile ducts.
The bile is stored in the gallbladder and, over time, becomes more concentrated, which makes it better at digesting fats.
The gallbladder releases bile into the digestive system when it’s needed.
Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. In most cases, they don’t cause any symptoms and don’t need to be treated.
However they can cause a variety of symptoms
- Pain : typical pain in the upper abdomen and right side of the abdomen can occur due to gall stones. Pain which is usually self limiting , lasting for a few hours is usually referred to as a biliary colic
- Intense pain with vomiting , nausea and fever can occur due to infection from stones within the gall bladder. This is referred to as cholecystitis. The condition usually requires hospitalization
- Jaundice: yellowing of the skindue to obstruction to the bile duct eithr from a stone slipping into the bile duct or from compression to the bile duct from stones.
- Pancreatitis:This occurs from gall stones, when a stone migrates down the bile duict and irritates the pancreas, resulting in inflammation of the pancreas ( pancreatitis)
What causes gallstones?
Gallstones are thought to develop because of an imbalance in the chemical make-up of bile inside the gallbladder.
In most cases the levels of cholesterol in bile become too high and the excess cholesterol forms into stones.
Diagnosis
Diagnosis of gall stones is usually made on an ultrasound examination of the abdomen . An ultrasound is a fairly accurate investigation for detection of gall stones and its complications.
Sometimes gall stones are detected by chance ( incidental ) during an ultrasound or another scan being carried out for an unrelated problem / different problem – in most instances these patients don’t need any treatment for asymptomatic stones.
Treatment of gall stones
Removal of the gall bladder- cholecystectomy is the only defined treatment for gall stones.
Removal of the gall bladder is done through the key hole ( laparoscopic ) method. 4 small incisions are done through the abdominal wall and the gall bladder is removed.In about 5-7% of all cases, the gall bladder cant be removed through the key hole ( laparoscopic ) the operation needs to be completed through an open operation by cutting through the abdomen ( usually with a 5-7 inch incision )
The operation takes about 60-70 mins to be completed and patients are discharged in 1-2 days after laparoscopic procedures and within 4-5 days after an open operation.
Complications of the operation
Gall bladder operation – cholecystectomy is a safe and very commonly performed operation. The reported complication rate of injury to the bile duct or other major surrounding structres is reported @ 03.%( 3 in a 1000).
Some shoulder tip discomfort may be present after a key hole operation , which settles within a few hours of operation.
At Discharge
You will be discharged in 1-2 days after a straightforward gall bladder operation .at discharge you would be given some basic medications and pain killer.Usually a follow up with the treating surgeon is required in 1-2 weeks time.
At discharge one would be independent and able to do ones regular activities .
A rest for 1 week is usually recommended after laparoscopic surgery following which one can usually return to work , after consultation with your treating surgeon. ( 2 weeks if you had an open operation ).
There are no long term side effects or complications of removing the gall bladder and patients return to their normal routine life as when healthy.
