The gallbladder is a small sac of bile (a digestive juice produced by the liver that is used in the breakdown of fats ). Fatty food, getting into the body, provokes the gallbladder to release bile into the small intestine.
The formations are small stones made of cholesterol, bile pigment and calcium salts, usually in a mixture. They are a common digestive disorder and affect about 15 percent of people aged 50 and over.
In most cases, formations do not cause any problems. However, prompt treatment may be needed if they block the ducts and cause complications such as infections or inflammation of the pancreas (pancreatitis).
Surgeons may remove the gallbladder (an operation called a cholecystectomy) if gallstones or other diseases of the gallbladder are causing problems. Methods include laparoscopic cholecystectomy or open surgery. The organ is not vital, the body can cope without it, therefore, if its removal is required, doctors prescribe the procedure immediately.
Approximately 70 percent cases of formation do not cause any symptoms. Symptoms may include abdominal and back pain (pain is usually infrequent but severe) that gets worse after eating fatty foods, jaundice, fever, and pain if the gallbladder or bile duct becomes infected.
The disease is more common in women than in men. It is also common in people who are overweight and genetically inherited.
There is no single cause of disease. In some people, the liver produces too much cholesterol. This can lead to the formation of cholesterol crystals in the bile, which turn into stones. In other people, stones form because the bladder does not empty.
Diagnosis of the disease
There are three main types of formations. Mixed - the most common type. They are made up of cholesterol and salts, and mixed stones tend to develop in groups. The second type is cholesterol stones.
They are primarily made up of cholesterol, a fat-like substance that is critical to many metabolic processes. Cholesterol stones can grow large enough to block the bile ducts. And finally, the third type is pigmented formations. In this case, the bile has a greenish-brown color due to special pigments. Gallstone pigment stones are usually small but numerous.
Doctors diagnose disease using a range of tests, including:
- general tests such as physical examination and x-rays;
- Ultrasound - sound waves form a picture that shows the presence of seals;
- endoscopic test – endoscopic retrograde cholangiopancreatography (ERCP);
- hepatobiliary iminodiacetic acid (HIDA) scan, a special type of scan that assesses how well an organ is functioning;
- Magnetic resonance cholangiopancreatography (MRCP) is a form of magnetic resonance imaging (MRI).
Complications of gallstones
Complications that may require surgery:
- colic - the stone may move from the body of the gallbladder into its cystic duct, resulting in obstruction (symptoms include severe pain and fever);
- inflammation of the gallbladder (cholecystitis) – a stone blocks the gallbladder duct, leading to infection and inflammation of the organ (symptoms include severe abdominal pain, nausea, and vomiting);
- jaundice - if a gallstone blocks the bile duct leading to the intestines, the bile enters the person's blood rather than the digestive system (pigments cause a person's skin and eyes to turn yellow, urine can also turn orange or brown);
- pancreatitis – inflammation of the pancreas caused by a blocked bile duct located low under the pancreas ( enzymes of the pancreas irritate and burn the pancreas and leak into the abdominal cavity);
- cholangitis is an inflammation of the bile ducts that occurs when the bile duct is blocked by a stone and the bile becomes infected (causing pain, fever, and jaundice).
Treatment of the disease
Treatment depends on the size and location of the stones, but may include dietary modifications such as limiting or eliminating fatty and dairy products.
Lithotripsy - a special machine generates sound waves to destroy gallstones. The treatment is only used in some centers for people with small and soft stones.
Some medications can dissolve stones, but this method is rarely used due to side effects and variable success rates.
About 80 percent of people with gallstones need surgery. During surgery, doctors may remove the entire gallbladder (cholecystectomy) or just stones from the bile ducts. Laparoscopic cholecystectomy is a laser-assisted operation. The surgeon makes several small incisions through the skin, providing access to various instruments. The doctor removes the gallbladder through one of the incisions.
Some things should be discussed with the doctor or surgeon before surgery, including tolerability of anesthesia, allergic reaction to drugs, drug use, etc.
The general procedure includes the following steps. The doctor makes several small incisions in the abdomen so that thin instruments can enter the abdominal cavity. A tube is inserted through which gas enters the abdominal cavity (separates the abdominal wall from the main organs). The surgeon observes the organ on a monitor using a tiny camera attached to a laparoscope. With the help of a laser, an organ is excised with a clamp of all arteries and ducts. After that, it is removed from the abdominal cavity through one of the previously made incisions. Gas is removed from the abdominal cavity, stitches are applied to the incisions, wounds are treated and covered with sterile dressings.
After surgery using a laser, there is a slight pain in the shoulder from carbon dioxide. If the pain is noticeable, the doctor may prescribe pain medication. It is also recommended to regularly cough to clear the lungs of a general anesthetic, move more and do not forget about dietary nutrition.
The whole operation carries a certain degree of risk. Possible complications after laser removal of the bladder include internal bleeding, infectious diseases, damage to nearby digestive organs, bile duct. Leakage of bile into the abdominal cavity can occur, as well as damage to blood vessels. It is important to visit your doctor within seven to ten days after your surgery to make sure everything is okay. The presence of complications (in rare cases) may require a second operation.