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Gallbladder Surgery

The Gallbladder

The liver produces bile which is drained to the gallbladder and stored. After food consumption the gallbladder releases the bile via the pancreas to the small bowel.  The bile then mixes with the food and aids in fat digestion.

Gallstones

  • Affects 10% of adults

  • Stones form in the gallbladder when the bile fluid becomes unbalanced leading to formation of bile precipitates known as gallstones

Risk factors for forming Gallstones

  • 80% are cholesterol and mixed gallstones

    • Multiple pregnancies

    • Obesity

    • Rapid weight loss

    • Ageing

    • Some ethnic groups

    • Female

  • 20% are bile pigments

    • Patients with blood disorders

Symptoms and Complications of Gallstones

  • Asymptomatic

  • Biliary colic

    • Intermittent passage of stones to the neck of the gallbladder causing:

      • Pain in the upper abdomen ± back

      • Nausea ± vomiting

      • Bloating

      • Worse after meals

      • Lasts <3 hours usually

  • Cholecystitis

    • Active infection of the gallbladder, requires antibiotics and usually hospitalisation

  • Choledocholithiasis

    • Gallstones travel from the gallbladder to the common bile duct

    • Very high risk of infection, bile duct obstruction and severe liver problems

  • Ascending Cholangitis

    • Associated with stones in the common bile duct causing a serious infection

    • Requires intensive care in hospital and an emergency ERCP (camera to retrieve the stones)

  • Pancreatitis

    • Stone passed into the pancreas blocking the duct and causing inflammation of pancreas

    • Can be slightly unwell or requiring intensive care

    • If blocks the duct needs ERCP

  • Mirrizi Syndrome

    • Large stone in the gallbladder causing external compression on the draining ducts causing obstruction

    • Needs urgent cholecystectomy

Indications for a cholecystectomy (gall bladder removal)

Gallstones causing

  • Recurrent biliary colic

  • Cholecystitis

  • Ascending cholangitis

  • Pancreatitis

  • Choledocholithiasis

  • Mirrizi Syndrome

  • Microlithiasis

  • Biliary dyskinesia

  • Large gallstones

Treatment of Gallstones

Surgery is the gold standard treatment for symptomatic gallstones.  This is usually performed as  laparoscopic (key hole) surgery with four small incisions and removal of the gallbladder.

Recovery from Surgery

Patients can be discharged the same or following day and return to usual activities, except for avoiding heavy lifting for 6 weeks to prevent hernia development.