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National Documentation Centre (NDC)

Gallbladder stone

How to reduce the risk of having gallstones (The Tribune-7 July 2010)

The gallbladder stone is one of the most common diseases in our region affecting all ages and strata of people. Here is some basic information.

What is gallbladder?

The gallbladder is a small organ located high on the right side of the abdomen (tummy) under the liver. In adults, it measures approximately 8 cm in
length and 4 cm in diameter when fully distended.

What is the gallbladder’s function?

The adult human gallbladder stores about 50-75 millilitres of bile which is released into the small intestine when
food containing fat enters it from the stomach. This bile along with the bile released directly from the liver helps in
the digestion of the fat present in the food.

What are gallbladder stones or gallstones? How are they formed?

Gallstones are small, hard substances which can sometimes develop in the gallbladder . There are two types of
gallstones- cholesterol stones and pigment stones. Eighty per cent of gallstones are cholesterol stones. The stones
can be multiple or single, and can vary in size from a salt’s grain to a golf-ball size.

What are the risk factors for developing gallstones?

Female sex, obesity, pregnancy, fatty foods and a few diseases like Crohn’s disease and thalassemia are all associated with an increased risk for
developing gallstones. Only first-degree relatives of patients with gallstones and obesity have been identified as strong risk factors for the
symptomatic gallstone disease.

What are the symptoms of gallstones?

To begin with, most gallstones do not cause symptoms. However, when gallstones become larger, or when they begin obstructing the neck of the
gallbladder, symptoms or “attacks” begin to occur. Attacks of gallstones typically occur after a fatty meal and at night. The common symptoms are
pain in the right upper part of the tummy, nausea and-or vomiting, abdominal bloating, intolerance of fatty foods, belching or gas, and indigestion.
Uncomplicated gallstones usually don’t cause jaundice, fever or longer lasting pain (more than 24 hours). These symptoms appear only after
complications of gallstones set in.

What are the complications associated with gallstones?

Complications generally result from infection or when the stone moves into the main duct-CBD. They are acute cholecystitis, pancreatitis, jaundice,
fever, intestinal obstruction, gallbladder cancer, etc. Therefore, the importance of timely treatment is paramount.

What is the treatment of gallbladder stones?

The standard treatment is the removal of the gallbladder surgically.

Is there any effect of gallbladder removal on the body?

The gallbladder removal doesn’t affect any functioning in the body. The liver produces the same amount of bile as it used to produce before the
gallbladder removal, and the common duct draining bile (CBD) dilates to accommodate the extra flow of bile. So, the gallbladder removal doesn’t
have any negative effect on the body
Can gallbladder stones be totally “silent” (not causing any symptoms)? Do they need to be removed?

Yes, in the case of some patients the gallstones can be totally silent, causing no symptoms at all. In these patients, the stones in the gallbladder are
accidentally detected when an Ultrasound is done for some other reason. Silent stones should be removed when they are associated with diabetes, if
these are of the stone size more than 2 cm, in the case of polyp in the gallbladder, porcelain(calcified) gallbladder and the regions where gallbladder
cancer is very common like the northern region of India.

What are the ways to remove the gallbladder?

The gallbladder can traditionally be removed by two methods- open and laparoscopic (keyhole). Now single hole laparoscopic surgery (single
incision laparoscopic surgery- SILS or scarless surgery) has revolutionised the way gallbladder surgery can be done.

In traditional open surgery, the gallbladder is removed through a 10-15 cm-long incision (cut) in the tummy. The cut is made just below the ribs on
the right side and it goes to just below your waist.

About 20 years back, a better way to remove the gallbladder called laparoscopic cholecystectomy was started. In this surgery, a laparoscope (a small,
thin tube with a camera on the tip of it that is used to see the inside of your body) is used to remove the gallbladder. Four small incisions (cuts) are
made rather than one large incision

In the latest, single incision laparoscopic surgery, complete surgery is done through a single small puncture-hole-incision of about 1.5 to 2.5 cms.
This small cut is made inside the navel (umbilicus) in such a way that the scar is practically invisible after the operation, making it a scarless surgery.
This method has revolutionised the field of surgery as laparoscopic surgery did about 20 years back.

The advantages of scarless surgery-

1. Wonderful cosmesis— The cosmetic result is fantastic as there is no visible scar after the operation.

2. Less pain — As the number of cuts are less, there is very little pain.

3. Early recovery

4. Early return to work

5. Less chances of infection, as there is only one small cut.

Can we prevent gallstones?

There is no sure way to prevent gallstone formation. But you can reduce your risk of having gallstones that can cause symptoms by maintaining a
healthy weight, eating regular and balanced meals, and exercising regularly.