Gall Bladders

 

What And Where Is The Gallbladder?

The gallbladder is located in the right upper abdomen tucked under the liver. The gallbladder stores and concentrates bile secreted by the liver and then releases it following a meal to aid digestion, especially after you consume fat.

What Causes Gallstones?

Bile is composed of various chemicals and when there is imbalance of these chemicals, it leads to the formation of gallstones. It is not clear why some people develop gallstones more than others, however, those most likely to suffer with this condition are:-

  • Women between the ages of 20 and 60years
  • Those who are overweight
  • Those who are trying to loose weight rapidly and on low calorie diets

What Are The Symptoms Of Gallbladder Disease?

Many people have gallstones which may not cause any symptoms at all. However, when symptoms occur they can cause a sudden and intense attack of abdominal pain located in the right upper abdomen or the centre of the upper abdomen. This type of gall bladder pain is often referred to as biliary colic. Bilary colic is painful and that pain can radiate through to the back and to the shoulders and last for several hours, leaving a tender discomfort in the abdomen. Gallstones can also be associated with chronic indigestion, abdominal indigestion, bloating, flatulence, nausea and vomiting.

What Are The Complications Of Gallstones?

The complications of gallstones may include:-

  • Inflammation of the gallbladder, known as acute cholecystitis. This is similar to the biliary colic previously described but with the addition of a fever and chills.
  • Blockage of the main bile duct (common bile duct) causing yellowing of the whites of the eyes and skin (jaundice) and dark urine. If you have fever and chills you may also have an infection in the bile duct (cholangitis), which must be treated as a matter of urgency.
  • Inflammation of the pancreas (acute gallstone pancreatitis) may occur when a stone blocks pancreatic duct where it meets the common bile duct. Acute inflammation in the pancreas is characterised by intense upper abdominal pain, which radiate to the back and tend to be associated with nausea and vomiting. This is a most serious and potentially is a potentially life-threatening complication of gallstones.

How Are Gallstones Diagnosed?

Ultrasound: This is the most sensitive test performed when looking for gallstones. Ultrasound machines utilise sound waves to bounce off the gallstones and other organs. These sound waves then create an image on a video monitor.

Magnetic Resonance Cholangiogram (MR scan): This is a non-invasive scanning device, which is usually used when there is a suspicion of a bile duct stone.

Endoscopic Retrograde Cholangiopancreotogram (ERCP): can be used to diagnose and remove stones from the bile duct. It involves passing a flexible camera tube down the throat into the small intestine. The flexible camera has a working channel through which fine instruments can be passed to inject a special dye to help locate bile duct stones and then remove or crush them. This procedure is usually performed under sedation or occasionally under under general anaesthesia.

Computed Tomogram: sometimes is used mainly in the evaluation of complications of gallstones.

How Are Gallstones Treated?

The only satisfactory treatment for problematic gallstones is surgery to remove both the gallstones & the gallbladder by a procedure known as a Cholecystectomy. This procedure is generally performed under general anaesthetic using a laparoscopic ‘keyhole’ technique and it is known as a Laparoscopic Cholecystectomy. This procedure is conducted by the surgeon making four small ‘key hole’ incisions in the abdominal wall, through which a miniature camera and thin instruments are inserted. These instruments are then guided inside the abdomen by the surgeon who removes the both the gallbladder and stones by viewing his work on a video screen. After the procedure the ‘keyhole’ incisions are then closed with dissolving stitches.

The advantages of a laparoscopic procedure over a more tradition open one, which requires a large incision are as follows:

  • Smaller incisions
  • Less postoperative pain
  • Less hospital stay
  • Quicker physical recovery
  • Less wound scarring

Regrettably in 2% of patients, it may not be possible to complete the procedure using the keyhole approach and if this is the case the operation will be converted to an open procedure. Your surgeon will discuss this possibility with you during your consultation and again prior to surgery.

What Is The Recovery Like After Surgery?

You will be able to eat and drink on the day of the operation. The operation is usually straightforward and most people are usually well enough to go home within twenty four hours. Most people should be well enough to engage in gentle sporting activities after 7 to 14 days.

There are no special dietary restriction following gallbladder removal and you can live without your gallbladder without any adverse affects to your health. In a small minority of individuals (1%), there may be increased bowel frequency following gallbladder removal because bile flows directly into the intestine from the liver but this usually settles down eventually.

Are There Any Risks Associated With Gallbladder Surgery?

All surgery involves an element of risk from developing complications. Risks such as bleeding, delayed healing, scaring, infection, nausea and vomiting, bowel damage and common bile duct damage will all be discussed openly at consultation with your surgeon, as well as his scrupulous efforts to manage and minimise these risks to their lowest potential.

Smoking will adversely affect wound healing and smokers may be precluded from having this type of surgery as a result.

Although gallbladder surgery is very regularly performed without any complications, all surgery, no mater how expertly or carefully it is performed, carries risks. The importance of a full evaluation and consultation to discuss your understanding and expectations in relation to these risks cannot therefore be over emphasised.

How Do You Find Out If You Are A Suitable Candidate For Gallbladder Surgery?

If you are unfortunate enough to have a problematic gallbladder then the only satisfactory method of treatment is surgery! However, how your surgery is performed will have a significant impact on how straightforward and speedy your recovery will be.

At East Midlands Bariatric Unit we understand the significant importance of the procedure you are considering and will spend time with you in consultation examining your problem in detail and considering the very best surgical option for you.

How Do You Make A Consultation Appointment?

At consultation you will be given both detailed information about the treatment options you are suitable for and encouraged to ask as many questions as would like. If after careful consideration you decide to have your gallbladder removed, then you will be treated swiftly at a time schedule to suit your personal needs and obligations.

If you would like to find out more about gallbladder surgery and discover if you are a suitable candidate for this procedure, please telephone or email the Easy Midlands Bariatric Unit to organise a consultation appointment

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