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Gallbladder Conditions and Treatment

  • Gallstones

    What is the gallbladder?
    The gallbladder is a pear-shaped structure that is found attached to the liver. The gallbladder is attached to the bile duct by a small tube called the cystic duct. Bile is empties into the bile duct through the cystic duct during a meal.

    What are gallstones?
    Gallstones are stone-like substances that are found in the gallbladder. There are two types of gallstones: pigment stones and cholesterol stones. In many people the cause for gallstones appears to be interaction between hereditary causes and the diet. In the majority of patients with gallstones, the gallbladder wall is abnormal due to many previous episodes of inflammation.

    What symptoms do gallstones cause?
    Gallstone causes symptoms that are usually associated with eating a fat rich meal. Many patients develop pain in the right upper part of the abdomen.Some patients complain of indigestion, fullness, and discomfort in the upper part of the abdomen after a meal.

    How are gallstones diagnosed?
    Gallstones are diagnosed by an ultrasound scan. An ultrasound is an excellent test for gallstones and diagnoses the stones in more than 98% of all patients with gallstones.

    What are the complications associated gallstones?
    Gallstones can cause many serious complications. Some of the complications that are caused by gallstones include:
    Acute cholecystitis: A stone blocks the cystic duct and the gallbladder cannot empty into the bile duct. The secretions in the gallbladder accumulate and become infected. Patients develop infection of the gallbladder with severe pain in the upper part of the abdomen, fevers and nausea and vomiting.
    Jaundice: Jaundice develops when a stone passes from the gallbladder and blocks the bile duct. Patients present with a yellowish discoloration of their skin associated with severe itchiness.
    Acute pancreatitis: Pancreatitis is one of the most severe complications of gallstones. Pancreatitis develops with severe pain in the abdomen and back that is associated with nausea, vomiting, and fevers.
    Cancer of the gallbladder: In some patients when gallstones are present
    over many years there is an increase risk of cancer in the gallbladder.

    How are gallstones treated?
    Gallstones are treated by removal of the gallbladder by a procedure called cholecystectomy. Cholecystectomy can be performed through an open surgical incision and by laparoscopic surgery. In the past the gallbladder was removed through an open surgical incision.

  • Laparoscopic cholycystectomy

    What is laparoscopic cholecystectomy?
    The surgery to remove the gallbladder is called a cholecystectomy. A less invasive way to remove the gallbladder is called laparoscopic cholecystectomy. This surgery uses a laparoscope (an instrument used to see the inside of your body) to remove the gallbladder. It is performed through several small incisions rather than through one large incision, usually 4 incisions, each one inch or less in length.

    What is a laparoscope and how is it used to remove the gallbladder?
    A laparoscope is a small, thin tube that is put into your body through a tiny cut made just below your navel. Your surgeon can then see your gallbladder on a television screen and do the surgery with tools inserted in three other small cuts made in the right upper part of your abdomen. Your gallbladder is then taken out through one of the incisions.

    Are there any benefits of laparoscopic cholecystectomy compared with open cholecystectomy?
    With laparoscopic cholecystectomy, you may return to work sooner, have less pain after surgery, and have a shorter hospital stay and a shorter recovery time. The incision is much smaller, which makes recovery go quicker. Because the incisions are smaller with laparoscopic cholecystectomy, the pain is less after this operation as after open cholecystectomy.

    Is there any reason why I wouldn’t be able to have a laparoscopic cholecystectomy?
    If you have previously had multiple abdominal surgery, if you tend to bleed a lot an open surgery may be better for you. Sometimes, your surgeon may begin doing the procedure laparoscopically and then convert to an open procedure.

    What are the complications of laparoscopic cholecystectomy?
    Complications may include bleeding, infection and injury to the duct that carries bile from your gallbladder to your small intestine. Also, during laparoscopic cholecystectomy, the intestines or major blood vessels may be injured when the instruments are inserted into the abdomen. All of these complications are rare.

  • Gallbladder and Bile Ducts

    What is the Gallbladder?
    The gallbladder is a pear-shaped structure that is found attached to the liver. The bile duct is a tube that transports bile from the liver to the small intestine. The gallbladder is attached to the bile duct by a small tube called the cystic duct. Bile is collected in the gallbladder between meals and empties into the bile duct through the cystic duct during a meal.

    What is the bile duct?
    The bile duct is long tube-like structure that connects the liver to the intestine. The liver makes bile that is required for the digestion of food. The bile from the liver is transported to the intestine by the bile duct.The top half of the bile duct is associated with the liver while the bottom half of the bile duct is associated the pancreas through which it passes on its way to the intestine. It opens in the part of the intestine called the duodenum into a structure called the Ampulla. Blockage of the bile duct by a cancer or scarring from injury prevents the bile from being transported to the intestine and the bile accumulates in the blood. This condition is called jaundice and the skin and eyes becomes yellow from the accumulated bile in the blood. This condition also causes severe itchiness.

    Common causes of jaundice:
    Jaundice is commonly causes by conditions such:
    • Pancreatic cancer: caused by blockage of the bile duct passing through the cancerous portion of the pancreas
    • Bile duct cancer.
    • Gallstones: Blockage by a stone in patients with gallstones.
    • Scarring after injury to the bile duct during gallbladder removal.

  • Gallbladder Conditions

    Common gallbladder problems:
    Any disease that affects your gallbladder is considered a gallbladder disease. The following conditions are all gallbladder diseases:

    Inflammation of the gallbladder:
    Inflammation of the gallbladder is called cholecystitis. It can be either acute or chronic. Chronic inflammation is the result of several acute cholecystitis attacks. Inflammation may eventually damage the gallbladder, making it lose its ability to function correctly.

    Gallstones are small, hardened deposits that form in the gallbladder. They may eventually cause problems, including inflammation, infection, and pain. As the gallstones grow in size, they can begin to block the channels that lead out of the gallbladder. Most gallstones are formed from cholesterol found in the gallbladder’s bile.

    Common bile duct stones:
    Gallstones can occur in the common bile duct. The common bile duct is the channel that leads from the gallbladder to the small intestine. In most cases, common bile duct stones develop in the gallbladder and then passed into the bile duct. Sometimes stones form in the common bile duct itself.

    Gallbladder disease without stones:
    Gallbladder disease without stones ( acalculous gallbladder disease) can occur. In this case, you may experience symptoms commonly associated with gallstones without stones.

    Common bile duct infection:
    An infection may develop if the common bile duct is obstructed. Treatment for this condition is successful if the infection is found early.

    Abscess of the gallbladder/empyema:
    A small percentage of people with gallstones may also develop pus in the gallbladder. If not diagnosed and treated, it can become life-threatening as the infection spreads to other parts of the body.

    Perforated gallbladder:
    If you wait too long to seek treatment, gallstones can lead to a perforated gallbladder. If the tear isn’t detected, a dangerous, widespread abdominal infection may develop.

    Gallbladder polyps:
    Polyps are growths that develop and are typically noncancerous. Small gallbladder polyps may not need to be removed. But larger polyps may need to be surgically removed before they develop into cancer or cause other problems.

    Porcelain gallbladders:
    A healthy gallbladder has very muscular walls. Over time, calcium deposits can stiffen the gallbladder walls and has risk of gallbladder cancer.

    Gallbladder cancer:
    Gallbladder cancer is rare. If it’s not detected and treated, it can spread beyond the gallbladder quickly.