Front View of the Gallbladder
The gallbladder is a small pouch that sits just under the liver. The gallbladder stores bile produced by the liver. After meals, the gallbladder is empty and flat, like a deflated balloon. Before a meal, the gallbladder may be full of bile and about the size of a small pear.
In response to signals, the gallbladder squeezes stored bile into the small intestine through a series of tubes called ducts. Bile helps digest fats, but the gallbladder itself is not essential. Removing the gallbladder in an otherwise healthy individual typically causes no observable problems with health or digestion yet there may be a small risk of diarrhea and fat malabsorption.
Cholelithiasis – Symptoms
Gallstones (Cholelithiasis) may cause no signs or symptoms. If a gallstone lodges in a duct and causes a blockage, the resulting signs and symptoms may include:
- 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
- Nausea or vomiting
- Fever and chills
- Gallstone pain may last several minutes to a few hours.
Causes
It’s not clear what causes gallstones to form. Doctors think gallstones may result when your bile contains too much cholesterol or bile contains too much bilirubin. Also when your gallbladder doesn’t empty correctly
Risk factors
Factors that may increase your risk of gallstones include:
- Being a woman
- Older age
- Obesity
- High cholesterol
- Taking medications that contain estrogen
- Losing weight quickly
- Diabetes
- Pregnancy
- Eating a high-fat diet
- A high-cholesterol diet
- Eating a low-fiber diet
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. Severe pain, jaundice, and bile duct infection can result.
- Blockage of the pancreatic duct. The pancreatic duct is a tube that runs from the pancreas and connects to the common bile duct just before entering the duodenum. 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.
Cholelithiasis – Diagnosis
Tests and procedures used to diagnose gallstones and complications of gallstones include:
- Blood tests: Your doctor may look for elevated bilirubin, a waste product in the blood that can signal a blocked bile duct. Tests may also look for abnormal pancreatic or liver enzyme levels, or signs of infection.
- Abdominal ultrasound
- Abdominal CT scan
If a more detailed look at your gallbladder and bile ducts is needed, your doctor may schedule the following procedure:
Endoscopic retrograde cholangiopancreatography: In an ERCP procedure, you are sedated and an endoscope (a long, thin tube) containing a tiny camera is passed down your throat into your bile ducts. Contrast dye and X-ray images are also typically used to view your gallbladder and surrounding structures in detail. (4)
Cholelithiasis – Treatment
Most people with gallstones that don’t cause symptoms will never need treatment. Your doctor will determine if treatment for gallstones is indicated based on your symptoms and the results of diagnostic testing. If gallstone signs and symptoms occur in the future, you can have treatment. The most common surgical procedure related to the gallbladder is removing it completely (cholecystectomy).
There are two methods of gallbladder removal.
- Laparoscopy, which is almost always the preferred method, involves making several small incisions through which surgical tools and a tiny video camera are inserted.
- Open surgery. This happens in 2-3 percent of laparoscopic gallbladder surgeries.
General Surgeon Nikos Vlachos, who specialized in Laparoscopic Surgery and is a member of the Hellenic Society of Endoscopic Surgery, is at your disposal to provide you with a personalized diagnosis and recommend the appropriate treatment.
Contact the doctor for any questions or clarification regarding this.
