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WHAT IS A GALL
BLADDER?
Gall Bladder is a small
pear-shaped organ that is about three to six inches
in length. It is found below the liver. Its function
is to store and concentrate bile, a greenish brown
fluid which is produced in the liver. |
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WHAT IS BILE?
Bile is a liquid produced by the liver which helps
the body to digest fat. Bile is made in the liver,
and then stored in the gallbladder until the body
needs to digest fat. During that time, the
gallbladder contracts and pushes the bile into a
tube called the common bile duct (CBD) that carries
it to the small intestine, where it helps with
digestion. |
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WHAT ARE
GALLSTONES?
Gallstones are formed
when bile stored in the gallbladder hardens into
pieces of stone-like material. They may vary in
number and size. Gallstones can block the normal
flow of bile if they get collected in any of the
ducts and carry bile from the liver to the small
intestine. |
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WHAT ARE THE
CAUSES OF GALLSTONES?
Although
gallstones are a very common medical problem, we
know very little aout why some people develop them
and some do not. However there are few people who
are at a greater risk of developing gallstones. |
- Age people over 60 years
of age are more likely to
develop
gallstones than younger people.
- Gender: women
between 20 and 60 years of age are twice as
likely to develop gallstones as men.
-
Obesity is a major risk factor for gallstones
especially in women.
- Excess estrogen: women
on birth control pills, hormone
replacement treatment etc.
-
Cholesterol-lowering drugs.
- Diabetes: People
with diabetes generally have high levels of fatty
acids called triglycerides. These fatty
acids increase the risk of
gallstones.
- Prolonged Fasting.
- Rapid weight loss. |
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WHO IS AT RISK
FOR GALL STONES?
Women are more
at risk than men. Overweight individuals and people
who fast or lose a lot of weight quickly can also
develop gall stones. Also pregnant women, women on
hormone treatment, and birth control pills for
prolonged period can be at risk for gall stones. |
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WHAT ARE THE
SYMPTOMS?
Symptoms of gallstones
are sudden and severe attacks of abdominal pain
often called a gallstone attack. |
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A TYPICAL
ATTACK CAN CAUSE:
- Steady pain
in the upper abdomen that increases rapidly and
lasts
from few minutes to several
hours.
- Pain in the back between the shoulder
blades.
- Pain under the right shoulder.
-
Nausea of vomiting.
Other
gallstones symptoms include:
- Gas
formation (bloating of abdomen).
- Persistent
intolerance to fatty foods.
- Belching.
-
Indigestion. |
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People who
also have the above and any of following symptoms
should see a doctor right away:
-
Chills.
- Low-grade fever.
- Yellowish
color of the skin or whites of the eyes.
-
Clay-colored stoods. |
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WHAT ARE “SILENT
STONES”
Many people with
gallstones show no symptoms. These patients are said
to be asymptomatic, and these stones are called
silent stones Treatment for these stones is
detectable. |
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WHAT ARE THE
COMPLICATIONS OF THESE STONES?
-
Obstruction of the common bile duct causing
jaundice.
- Inflammation (swelling and painful
condition) or infection of the
gallbladder (acute cholecystitis).
-
Inflammation or infection of the liver
(cholangitis), which can occur
when
gallstones enter the common bile duct. Through not
common,
this can lead to the death of
tissue.
- Inflammation of the pancreas
(pancreatitis).
- Severe infection with pus
filling the gallbladder (empyema).
- An
abnormal connection (fistula) between the
gallbladder and small
intestine.
-
A hole in the gallbladder (perforation).
-
Gallbladder cancer (I in 1,000 per year in people
with gallstones). |
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HOW ARE
GALLSTONES FOUND AND TREATED?
Ultrasound is most commonly used to find gallstones.
In a few complex cases. Other X-ray tests may be
used to evaluate gallbladder disease. Gallstones do
not go away on their own. Some can be temporarily
managed with drugs or by making dietary adjustments,
such as reducing fat intake. This treatment has a
low, short-term success rate. Symptoms will
eventually continue unless the gallbladder is
removed. Surgical removal of the gallbladder is the
safest treatment for gallbladder disease.
While watching the monitor, the surgeon uses the
instruments to carefully separate the gallbladder
from the liver, ducts and other structures. Then the
cystic duct is cut and the gallbladder removed
through one of the small incisions.
Because the abdominal muscles are not cut during
laparoscopic surgery, patients have less pain and
fewer complications than they would have had after
surgery using a large incision Because the abdominal
muscles are not cut during laparoscopic surgery,
patients have less pain and fewer complications than
they would have had after surgery using a large
incision across the abdomen. Recovery usually
involves only one night in the hospital, followed by
several days of restricted activity at home.
If the surgeon discovers any obstacles to the
laparoscopic procedure such as infection or scarring
from other operations, the operating team may have
to switch to open surgery. In some cases the
obstacles are known before surgery, and an open
surgery is planned, It is called open surgery
because the surgeon has to make a 5 to Binch
incision in the abdomen to remove the gallbladder.
This is a major surgery and may require about a 2 to
7 days stay in the hospital and several more weeks
at home to recover. Open surgery is required in
about 5 percent of gallbladder operations. |
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WHAT ARE THE
ADVANTAGES OF PERFORMING THE PROCEDURES
LAPAROSCOPICALLY?
- Rather than a
five to seven inch incision, the operation requires
only
four small openings in the
abdomen.
- Patients usually have minimal
post-operatic pain.
- Patients usually
experience faster recovery than open gallbladder
surgery patients.
- It can be
performed as a day care procedure. Most patients go
home within one day and enjoy a quicker
return to normal activities. |
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WHAT IS
EXPECTED AFTER GALLBLADDER SURGERY?
Gallbladder removal is a major abdominal operation
with a certain amount of postoperative pain. Nausea
and vomiting are not uncommon. Once liquids or a
diet is tolerated, patients leave the hospital the
same day or day following the laparoscopic
gallbladder surgery. Activity is dependent on how
the patient feels. Walking is encouraged. Patients
can remove the dressing and take a shower a day
after the operation. Patient will probably be able
to return to normal activities.
The gall
bladder is an organ that people can live without. A
change in the diet is also not required. After the
gall bladder is removed surgically, bile flows out
of the river through the hepatic ducts into the
common bile duct and directly into the small
intestine instead of being stored in the gall
bladder. |
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Points to
remember
- Gallstones from when
substances in the bile harden.
- Gallstones are
more common among older adults women, and
people who are overweight.
- Gallstone
attacks often occur after eating a meal.
-
Symptoms can mimic those of other problems,
including heart
attack, so accurate
diagnosis is important.
- Gallstones can causes
serious problems if they become trapped in
the bile ducts.
- Laparoscopic surgery
to remove the gallbladder is the most
common treatment. |
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WHAT
PREPARATION IS REQUIRED AFTER ADMISSION FOR SURGERY?
Preoperative preparation includes blood work medical
evaluation, chest X-ray and EKG depending on your
age and medical condition. The surgeon reviews with
the patient the potential risks and benefits of the
operation. The patient will have to provide written
consent for surgery. The surgeon may request that
the patient completely empties colon and cleanse
intestines prior to surgery. The patient may be
requested to drink clear liquids, only for one or
several days prior to surgery.
It is
recommended that the patient takes a shower the
night before or morning of the operation. After
midnight the night before the operation the patient
should not eat or drink anything except medications
that the surgeon has permitted to take with a sip of
water the morning of surgery. Drugs such as aspirin,
blood thinners, anti-inflammatory medications
)arthritis medications) and vitamin E will need to
be stopped temporarily for several days to a week
prior to surgery. |
