Gallbladders

Gallbladders

What is a gallbladder?

The gallbladder is a pear shaped organ located in the upper right part of your abdomen under the rib cage where it is attached to the liver. It’s job is to store the bile that the liver produces and release it for the digestion process when required. It’s only function therefore is storage.

How do Gallstones form?

Gallstones can form due to an imbalance in the bile constituents. Bile is formed by cholesterol, bilirubin  and bile salts. Any imbalance in these can cause stones to form, predominantly cholesterol stones.  Stones can also form if the gallbladder does not empty completely or frequently enough.

Who is at risk?

Women tend to be at a higher risk of developing gallstones. The extra oestrogen can cause cholesterol levels to increase and also affect  gallbladder contractions which causes gall stones to form. Oestrogen levels are higher during pregnancy and if you take contraceptive pills.

Other conditions causing increases in cholesterol levels include: obesity, diets which are high in calorie and refined carbohydrates, people who have Type 2 Diabetes or Crohn’s disease

People with a family history of gallstones are also at a higher risk.

What are the symptoms?

Symptoms include: Pain in the upper abdomen and chest moving to the right shoulder and between the shoulder blades. They can also cause nausea or vomiting. You may also experience a fever with or without chills but this is more likely to be associated with infection.

Complications

If the gallstones moves in to the bile pipe it can result in:

  • Jaundice – Yellowish discoloration of eyes, skin and orange coloured urine
  • Pancreatitis – Sharp squeezing pain in the upper abdomen and back.

Investigation

It is likely that you will have blood tests to check your liver functions and possibly an ultra sound scan of your abdomen to confirm gallstones are present. MRI scans are occasionally required to check that the bile pipe is clear.

What is the treatment?

If you have symptomatic gall stones you will require surgery to remove your gall bladder. It is common practice to perform this as a key hole (Laparoscopic) operation. Four small incisions are made in your abdomen. A small telescope with a camera (Laparoscope) is used to look inside your abdomen and your gall bladder will be removed through these small incisions. Absorbable sutures will be used to close the incisions.

The benefit of having key hole surgery is that most patients are discharged the same day.

In a small number of patients it may not be possible to perform key hole operation as the nature of their gallstones may require an open procedure. This is a judgement decision made before or sometimes during the operation. The decision is made purely for the benefit and safety of the patient.

What is the recovery time?

Most patients will go home on the day of surgery especially if they have had key hole surgery. Some may stay overnight and go home the next day. It really depends on each individual patient and how they feel post-surgery. You can expect to get back to normal activity in about a week.

Depending on the type and nature of your job, you can expect to return to work within two weeks.

You can usually return to eating a normal diet because the fat in the diet will not cause colicky abdominal pain. However,  you may experience loose bowels with fat in your diet. The cause for this is not entirely clear although it is thought to be due to excess bile specially bile acids entering the colon and acting as a laxative. If this occurs, you may have to lower the fat content in your diet to resolve it.

What are the risks?

The majority of patients experience few or no complications after key hole surgery.

In rare cases, there may be complications such as bleeding, infection, hernia and blood clots. Other risks include damage to adjacent structures such as bile pipe, large and small bowel and bile leak, which may require further surgery to rectify.

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