Gallstones

Gallbladder conditions
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What are Gallstones?

Gallstones are small stones that form in the gallbladder. The gallbladder is a small pear-shaped organ found underneath the liver. Its main purpose is to store bile with a capacity from 50 to 100mls and it also concentrates the bile to make it effective for digestion of fats. Bile flows from the liver into the gallbladder through tiny tubes known as bile ducts. The gallbladder releases bile into the small bowel when food is consumed. If the gallbladder becomes diseased and starts giving pain, this can be removed without affecting the digestive system. If not removed, this can continue to give symptoms and may result in complications like infection and jaundice, rarely cancer.

Anatomy of the biliary tree and the different locations where gallstones can lodge
The close correlation between the gallbladder and small intestine (duodenum) and impact of gallstones on the biliary tree

Symptoms associated with gallstones

Approximately 15% of the UK population is affected with gallstones and almost 50,000 gallbladder removal operations (cholecystectomy) are performed every year. Gallstones affect females more than males. Patients most commonly experience the following symptoms:

  • Nausea / vomiting; especially after a fatty meal (fat intolerance)
  • Upper abdominal pain; notably under the right rib cage which can last for a few hours
  • Dyspepsia/indigestion; heart-burn and eructation
 
The common locations of gallstones and where obstructions of the biliary tree occue
Gallstones are small stones that form in the gallbladder

Complications associated with gallstones

If untreated gallstone can result in the following complication:

  • Biliary Colic – pain due to gallstones passing through the cystic duct
  • Cholecystitis – infection in the gallbladder
  • Perforation of the gallbladder
  • Jaundice – gallstones blocking the bile duct
  • Gallstone ileus – gallstones causing blockage in the small bowel. This is rare complication
 
 

Diagnosis of gallstones

Gallstones are diagnosed with ultrasonography. If the gallstones have passed down the bile duct then an MRI scan is used.

Treatment of gallstones

Laparoscopic cholecystectomy (Keyhole removal of Gall bladder) is the current gold standard for symptomatic gallstones. This procedure is usually performed as a day case or one-night stay in the hospital. Recovery from the operation is quick but varies from patient to patient. Most patients are able to go back to normal activities in under a week following the operation. No dietary restrictions or supplements are needed after gallbladder removal.

REPEAT
A laparoscopic cholecystectomy (removal of the gallbladder) is the current gold standard for symptomatic gallstones