Digestive Health Digestive Health Basics

Surgical Treatment for Gallstones

What is the gallbladder and why do you need it?
The gallbladder is a small, pear-shaped organ that lies just beneath the liver in the upper right part of your abdomen. The gallbladder collects and stores bile, a digestive juice produced by the liver, and excretes it (through the common bile duct)the into the intestines. The purpose of bile is to help digest large fatty meals.

What are gallstones (cholelithiasis)?
Sometimes, stones (usually made of cholesterol, bile salts and lecithin) form in the gallbladder and block its outlet, causing pain (biliary colic) or inflammation and infection (cholecystitis). Sometimes the stones move out of the gallbladder but get stuck in the common bile duct, and can cause inflammation of the pancreas (pancreatitis), fever, or jaundice (yellow color in the skin and eyes). Pain usually begins after a meal and may become severe and constant. There may be more symptoms after eating fatty foods. Other symptoms may include bloating, belching, vomiting, and indigestion. Some patients have no symptoms.

How are gallstones diagnosed?
Diagnosis is most often made by ultrasound, the same technique used to visualize fetuses in pregnant woman. With this technique, a detailed image of the gallbladder contents, including stones, can be produced.

Who gets gallstones?
Men, women, and children can all get gallstones. They appear to be more common in obese women over the age of 40. Native Americans and Hispanics may also have higher rates. The overall incidence is 1 out of 1000 people. Women who exercise regularly may reduce their chance of getting gallstones.

What causes gallstones?
The causes are still mostly unknown, although it is presumed that changes in the composition of the bile substance and failure of the gallbladder to empty properly are contributing causes.

What is the treatment for gallstones?
Medication and adjustments in the diet (low fat) can help alleviate some of the symptoms. However, if stones block the gallbladder outlet or are lodged in the bile duct, surgery is indicated. Patients who have symptoms, even minor ones, have a diseased gallbladder and should strongly consider surgery. For patients with no symptoms, there is a significant risk that the first attack will be severe and require hospitalization; for this reason, such patients should also consider surgery. Furthermore, patients who are at increased risk for infection (such as diabetics or people undergoing chemotherapy) should consider removal of a diseased gallbladder. For these patients, a severe and acute attack may be very dangerous.

Gallbladder Surgery
There are two ways to perform gallbladder surgery: open cholecystectomy or laparoscopic cholecystectomy.

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