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Introduction

The Gallbladder is a small pouch which is a storehouse for excess bile. It is just below the liver and joins the main bile draining ducts.

When we eat, the gallbladder contracts so as to expel bile into the intestine for digestion of fats.


What are gallstones?

Gallstones or cholelithiasis (from the Greek chol (bile)- lith (stone)- iasis (process)) are formed due to cholesterol forming stones in the gallbladder.

Why do gallbladder stones occur ?

No particular reason, but it occurs more in females, people with diabetes; those with a family history of gallstones; people who are overweight, obese, or undergo rapid weight loss; and those taking cholesterol-lowering drugs. With age the incidence of gallstones increases.

Why do I need gallbladder surgery?

If you are symptomatic, then you need surgery. It’s your body’s way of telling you that your gallbladder is not functioning properly. Asymptomatic gallbladder stones are generally not operated on. Any complication is heralded by some symptoms.

Symptoms of Gallbladder stones

Symptoms can range from vague bloating, a feeling of indigestion, or pain.

Pain is usually in the right side of the upper abdomen or in the middle. It is usually severe, but can vary in intensity. Pain can be over the right shoulder too (referred pain).

In patients with diabetes, these tend to be very easily ignored because of lesser perception of pain - till some serious complication sets in.

Complications can be pus forming in the gallbladder, perforation of the gallbladder, obstructive jaundice (stone slipping from the gallbladder into the main bile passage and obstructing the bile flow), pancreatitis (inflammation of the pancreas).


Treatment

01

The gold standard treatment for symptomatic gallstones is laparoscopic cholecystectomy (keyhole gallbladder removal) . We have emphasized on ”removal” because in a gallstone problem the gallbladder needs to be removed unlike kidney stones, where only the stones are removed and not the kidney.

02

Once gallstones give trouble, the gallbladder becomes inflamed and subsequently non-functional. Hence retaining it serves no purpose. Additionally – retaining a diseased gallbladder can predispose to further severe complications like pus formation/cancer developing.

03

Hence a simple surgery is done– where the connection between the gallbladder and the main bile draining ducts is clipped and cut and the gallbladder is removed from one of the keyholes made for surgery. The integrity of the main biliary tract is maintained, and only the diseased reservoir is removed.

04

If there is much inflammation around the gallbladder, or difficulty in surgery, there may be a possibility to leave a small part of the gallbladder behind while removing the majority of the gallbladder with the stones. This small part of the gallbladder is closed off or left open depending on the inflammation and a drain is kept to the area, which is subsequently removed