Gallbladder Stones (Gallstones)
What is the Gallbladder?
The gallbladder is a pear-shaped, hollow structure located under the liver and on the right side of the abdomen. Its primary function is to store and concentrate bile, a yellow-brown digestive enzyme produced by the liver. The gallbladder is part of the biliary tract. Bile is important for breaking down fats in our digestive system.
What are gallstones?
Gallstones are hard, pebble-like pieces of material, usually made of cholesterol or degraded product of red blood cells (bilirubin), that form in your gallbladder. Gallstones can range in size from a grain of sand to a golf ball. The gallbladder can make one large gallstone, hundreds of tiny stones, or both small and large stones.
Symptoms of gallstones:
- Silent gallstones: most of the patients with gallstone have no symptoms, only stones found incidentally on abdominal imaging during a normal health check without complication
- Gallstone related complications: happen when the stones block any part of biliary tract which symptoms and severity are vary, depend on the site of obstruction and superimpose infection
- Symptomatic gallstone: happen when the stones block at cystic duct (tube that connect gallbladder to bile duct) temporalily. Symptoms can be ranged from indigestion, bloating, gassiness (dyspepsia), to severe abdominal pain at epigastrium or under right costal area, sometimes the pain can radiate to back.
- Cholecystitis (inflammation of gallbladder): If the stones block the cystic duct for a while, gallbladder can become infected. Patients symptoms include; more severe abdominal pain, fever, nausea and vomiting. The wall of the gallbladder and upper abdomen becomes tender and sensitive when tapped or pushed.
- Jaundice: if the stones fall out from gallbladder through cystic duct into the bile duct, it can block the drainage of bile. Patients usually had pain and their skin and eyes can turn to yellow.
- Cholangitis (infection of bile duct): blockage of bile duct by the stones can followed by an infection which can potentially severe and life threatening. Symptoms consists of fever, colicky pain, jaundice, and shaking caused by blood stream infection.
Pancreatitis: due to the opening of the pancreatic duct is share with the bile duct, if the stones (usually small sand stone) pass through the pancreatic duct, it can leads to pancreatic inflammation. Patients will experience severe pain in the abdomen and may also radiate to the back which lasts for a few days.
Patients experiencing these symptoms should see a specialist as soon as possible as more severe complications could occur.
Hospital Diagnosis and Treatment
- An ultrasound of the abdominal area will be sufficient to confirm whether or not you have gallstones or gallbladder inflammation. However, in complicated cases, to identify bile duct stones or to demonstrate the inflammation of the pancreas, the special imaging such as CT or MRI may needed.
- After the diagnosis of gallstones related complications, the doctor will consider the surgical gallbladder removal to prevent any further complications. This is done to ensure no further recurrence or complications. Nowadays, laparoscopic cholecystectomy (gallbladder removal) is the standard surgical procedure in patiets with complicated gallstones, due to its minimally invasive, and faster recovery. The size of the incision is minimal (0.5-1cm). The surgery is short (60-90 minutes) with recovery and length of hospital stay being short (3 days, 2 nights).
Getting back to normal
Your surgeon can give you specific advice about when you can return to your normal activities.
Generally speaking, after laparoscopic surgery you can:
- eat a normal diet straight away – you can return to a normal diet even if you were advised to avoid certain foods before your operation, although you should try to have a generally healthy and balanced diet (read more about diet after gallbladder surgery)
- do gentle exercises, such as walking – but be careful not to push yourself too hard, too soon and ask your surgeon or GP for advice about returning to more strenuous exercise
- drive again after a week or so – but first, make sure you can wear a seatbelt and practice an emergency stop without feeling any discomfort