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GALLBLADDER STONES

Gallstones

Have you been diagnosed with Stones in your Gall Bladder?

Have you been advised regarding the need for surgery for your Gall Bladder Stones?

Are you worried that your pain may recur if you do not have the surgery?

Let me try to explain about the basic facts about stones in the Gall Bladder

What are Gall Bladder Stones and How do they Form?

What are the Symptoms of Gall Bladder Stones?

What are the Risk Factors?

When to see a surgeon?

What are the possible Complications?

What investigations are required?

What are the treatment option for Gall Bladder Stones?

My Reassurance to you: Surgery for Gall Bladder Stones, known as Cholecystectomy, has been standardized and is a safe surgery, when performed by a surgeon experienced in both Laparoscopic & Open approach.

Minimal Invasive Surgery for Gall Bladder Stones, known as Laparoscopic Cholecystectomy, is considered the gold standard treatment worldwide.

Gallbladder anatomy

What are Gall Bladder Stones and How do they Form?

Gallstones are hardened deposits of bile that form in the Gall Bladder.

The Gall Bladder(GB) is a small pear shaped organ on the right side of the upper abdomen, just below the Liver.

The GB collects the Bile, a digestive fluid formed in the Liver, as it flows from the Liver to the Small Intestine.

The bile is a fluid that is made to help in digestion, esp. of the Fat in the diet.

The bile also contains cholesterol & bilirubin.

Gallstones start forming when the cholesterol & the bilirubin start clumping together to form cluster or a solid lump.

Over a period of time, these stones can grow in size.

GallBladder Stone

What are the Symptoms of Gall Bladder Stones?

 

Most of the time these gallstones do not cause any symptoms and are usually detected when the patient gets an Ultrasound (USG) scan for some other unrelated problem.

These are known as incidentally detected Gallstones.

However, sometimes Gallstones can cause symptoms, if they get caught in the narrow outlet of the Gallbladder or in the narrow ducts which drain the Liver & Gallbladder and connect them to the small intestines.

 If a gallstone lodges in a duct and causes a blockage, signs and symptoms may result, such as:

  • Sudden and rapidly intensifying pain in the upper right portion of your abdomen
  • Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone
  • Back pain between your shoulder blades
  • Pain in your right shoulder

Gallstone pain may last several minutes to a few hours.

RISK FACTORS:

 

Factors that may increase your risk of gallstones include:

  • Being female
  • Being age 60 or older
  • Being overweight or obese
  • Being pregnant
  • Eating a high-fat diet
  • Eating a high-cholesterol diet
  • Eating a low-fiber diet
  • Having a family history of gallstones
  • Having diabetes
  • Losing weight very quickly
  • Taking some cholesterol-lowering medications
  • Taking medications that contain estrogen, such as hormone therapy drugs

Do remember that you may still have gall bladder stones even if you do not have any of the above mentioned risk factors.

WHEN TO SEE A SURGEON

 

Make an appointment with your doctor if you have any signs or symptoms that worry you.

Seek immediate care if you develop signs and symptoms of a serious gallstone complication, such as:

  • Abdominal pain so intense that you can't sit still or find a comfortable position
  • Yellowing of your skin and the whites of your eyes
  • High fever with chills.

♦♦ COMPLICATIONS ♦♦

Complications of gallstones may include:

  • Inflammation of the gallbladder:  A gallstone that becomes lodged in the neck of the gallbladder can cause inflammation of the gallbladder (Cholecystitis). Cholecystitis can cause severe pain and fever.
  • Blockage of the common bile duct: Gallstones can block the tubes (ducts) through which bile flows from your gallbladder or liver to your small intestine. Jaundice and bile duct infection can result.
  • Blockage of the pancreatic duct: The pancreatic duct is a tube that runs from the pancreas to the common bile duct. Pancreatic juices, which aid in digestion, flow through the pancreatic duct. A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and usually requires hospitalization.
  • Gallbladder cancer: People with a history of gallstones have an increased risk of gallbladder cancer. But gallbladder cancer is very rare, so even though the risk of cancer is elevated, the likelihood of gallbladder cancer is still very small.

INVESTIGATIONS

Tests and procedures used to diagnose gallstones include:

  • Tests to create pictures of your gallbladder: Your doctor may recommend an abdominal ultrasound and a computerized tomography (CT) scan to create pictures of your gallbladder. These images can be analyzed to look for signs of gallstones.

  • Tests to check your bile ducts for gallstones: A test that uses a special dye to highlight your bile ducts on images may help your doctor determine whether a gallstone is causing a blockage. Tests may include a hepatobiliary iminodiacetic acid (HIDA) scan, magnetic resonance imaging (MRI) or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones discovered using ERCP can be removed during the procedure.
  • Blood tests to look for complications: Blood tests may reveal an infection, jaundice, pancreatitis or other complications caused by gallstones.

SURGICAL TREATMENT FOR GALL BLADDER STONES

LAPAROSCOPIC CHOLECYSTECTOMY

Laparoscopic Cholecystectomy

Laparoscopic Cholecystectomy is the gold standard worldwide and is the most commonly used procedure.

Compared to the open procedure, which involves a big incision, the Laparoscopic procedures entails only 04 tiny incisions ranging between 5mm to 10mm.

The advantage of the laparoscopic procedure is better visualization, more ergonomic operative procedure, less amount of post operative pain and earlier return back to daily activities.

Surgery comparision

This picture compares the two most commonly used procedures for Cholecystectomy.

Surgical treatment for Gall Bladder stones involves Cholecystectomy, which is the removal of the Gall Bladder.

This can be done either in the traditional method known as Open Cholecystectomy or the current gold standard method known as Laparoscopic Cholecystectomy, Key Hole surgery for Gall Bladder.

Your doctor may recommend surgery to remove your gallbladder.

Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder.

You don't need your gallbladder to live, and gallbladder removal doesn't affect your ability to digest food, but it can cause diarrhea, which is usually temporary.

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