Gallstones & Gallbladder Surgery

What is Your Gallbladder?

The gallbladder is a hollow, pear-shaped organ below the liver. Its primary function is to store bile, a thick yellow-green liquid produced in the liver.

Bile aids in the digestion of fatty foods.

Stored bile drains from the gallbladder into the common bile duct, opening into the small intestine.

Gallstones are common. Approximately 10% of men and 25% of women have gallstones. However, most are asymptomatic and do not require treatment.

Most gallstones are made from cholesterol and are frequently mixed with calcium and bile pigments.

Gallstones

Causes of Gallstones

Gallstones are formed when there is an imbalance of bile salts, phospholipids and cholesterol within the bile.

Kidney stone, urinary stone, ureteric stone, renal calculi, renal colic, nephrolithiasis

Risk factors for gallstone formation include:

Obesity
Gender - more common in women
Increasing age
Family history of gallstones
Oestrogen - Excess oestrogen from pregnancy, hormone replacement therapy, or birth control pills. Women between 20 and 60 are twice as likely to suffer from gallstones as men.
Cholesterol-lowering drugs.
Diabetes - People with diabetes generally have high levels of fatty acids called triglycerides.
Liver cirrhosis
Rapid weight loss - As the body metabolises fat during rapid weight loss, it causes the liver to secrete extra cholesterol into bile.
Spinal cord injury
Total parenteral nutrition

Signs of Gallstones

Symptoms may vary and often follow fatty meals, which may occur at night.

Typical symptoms include:

abdominal bloating and abdominal pain
recurring intolerance of fatty foods
steady pain in the right side of the upper abdomen
pain in the back between the shoulder blades
pain under the right shoulder
nausea or vomiting
Indigestion and belching

The pain in the upper abdomen may increase and last from 30 minutes to several hours and resolves on its own.

Symptoms of gallstone disease can mimic a heart attack, appendicitis, gastric ulcers, irritable bowel syndrome, reflux, pancreatitis, and hepatitis.

An accurate diagnosis is important.

Diagnosis of Gallstones

Various tests may be required to confirm the existence and nature of gallstones. These include:

Blood Tests
Ultrasound
Computed tomography
Magnetic resonance imaging (MRI)

Gallbladder Disease

Usually, gallstones do not cause any problems, but if gallstones block the gallbladder outlet, trapping the bile in the gallbladder, pain and secondary infection of the gallbladder can result.

Gallstones are responsible for the majority of gallbladder diseases. Gallstones may lead to gallbladder inflammation, known as cholecystitis, they may block the main bile ducts and they can cause pancreatitis. Less commonly, gallstones can cause other conditions can such as bowel obstruction and be implicated in development of gallbladder polyps and, rarely, gallbladder cancer.

What is Gallbladder Surgery?

Gallbladder surgery, or cholecystectomy, is a surgical procedure to remove the gallbladder. It is usually recommended for the treatment of symptomatic gallstone disease. It may also be recommended for management of biliary dyskinesia (abnormal gallbladder emptying), polyps and gallbladder cancer.

The procedure is performed laparoscopically (keyhole surgery) and can be performed as a same day surgery.

Additional procedures may be performed as part of the operation such as a cholangiogram (intraoperative X-ray) to delineate the anatomy of the bile ducts and check for stones. Common bile duct exploration may additionally be performed to remove gallstones lodged in the bile ducts.

Gallbladder Surgery Recovery

After gallbladder surgery, following a well-planned recovery plan can help ensure a smooth and successful healing process. While every individual's recovery may vary, here are some general guidelines for a gallbladder surgery recovery plan:

Rest and recovery: Follow your surgeon's advice on how much rest you need and gradually increase your activity levels as you feel able to. Most people will take 7-10 days off work.
Pain management: Take the medication as prescribed and as needed, following the instructions provided by your healthcare provider.
Incision care: Keep the incision sites clean and dry as instructed by your surgeon.
Diet and eating habits: Initially, you may be advised to follow a low-fat diet to allow your body to adjust to the absence of the gallbladder. Gradually introduce regular foods as tolerated, and listen to your body's cues regarding what foods may cause discomfort or digestive issues.
Physical activity: Initially, focus on gentle activities such as short walks, gradually increasing the duration and intensity as your surgeon advises. You will need to avoid heavy lifting and strenuous physical activity for 4 weeks after surgery.
Medication management: You may resume your usual medication after surgery. Your surgeon will advice you when to resume blood thinners or antiplatelet medications.
Follow-up appointments: Attend all scheduled follow-up appointments with your surgeon. These appointments are important for monitoring your recovery, removing any necessary stitches or staples, and addressing any concerns or questions.
Gradual return to normal activities: Gradually resume your normal activities, including work, as you can and as your surgeon advises. Listen to your body and avoid pushing yourself too quickly. It's important to give yourself enough time to recover fully.