What is a gallbladder?

The gallbladder is a pear-shaped organ that is located in the right upper side of the abdomen under your liver. Its main function is to store bile, which is a fluid made by your liver to break down fats that you eat. After a meal, bile is secreted by the gallbladder when the small intestine secretes a hormone cholecystokinin. The bile flows into the small intestine and helps to digest fats that the foods contain. The gallbladder also acts as a reservoir for the bile that is not being used by the body.

What are gallstones?
Gallstones are small solid pieces of material usually made of cholesterol, which form in the gallbladder. In many cases, they do not cause symptoms and do not need to be removed.

However, if the gallstones are trapped in the bile duct of the gallbladder, you will suddenly feel an intense pain and need to be treated immediately.

What are symptoms of gallstones?
You may not even experience symptoms or know you have gallstones, unless your doctor tells you. But if you do, symptoms include:

  • Sudden, intense abdominal pain that is felt in the middle of your abdomen or your right-hand side that may last for several hours
  • This pain often spreads to your back or right shoulder or shoulder blade
  • Nausea or vomiting
  • Yellowing of your skin or eyes, which is called jaundice
  • Fever or chills

What causes gallstones?
When cholesterol levels in the blood are too high, this excess cholesterol hardens and turns into stone. This is how gallstones develop in 80 per cent of gallstone cases. In the remaining of 20 per cent of gallstone cases, gallstones result from the hardening of unusually high levels of a waste product called bilirubin in the gallbladder.

What places you at risk of gallstones?

Dietary factors form a huge component of gallstones. You may be at risk of gallstones if you

  • are overweight or obese
  • consume a low-fiber, high-fat and high-cholesterol diet
  • had rapid weight loss recently

Other factors that increase your risk of gallstones is

  • having a family history of gallstones
  • taking birth control pills or hormones
  • having liver disease
  • having diabetes

How is gallstones diagnosed?
Your doctor will assess you in a physical examination. You may be scheduled to undergo diagnostic imaging tests such as blood tests, ultrasound scan, CT scan, cholangiography and MRI scan to check for abnormalities in your gallbladder.Blood tests can test for infection or other conditions such as pancreatitis and jaundice which is caused by gallstones. Ultrasound scan or CT scan provide images of your gallbladder. The doctor analyses the images for signs of gallstones.

Cholangiography is performed by using a dye that shows up on X-rays. The dye may be injected using an endoscope through your mouth, or into your blood or even directly into your bile ducts during surgery. After this, X-ray images are taken. If your gallbladder and bile systems are functioning normally, the dye will be absorbed in specific places. Otherwise, the images will reveal abnormalites in your bile or pancreatic systems. If a blockage has been detected, an endoscopic retrograde cholangio-pancreatography (ERCP) will be carried out. During this procedure, your doctor removes the blockage using an endoscope.

MRI scan is carried out to check for gallstones in the bile ducts. This scan uses strong magnetic fields and radio waves to produce detailed images of the organs in the body.

Why laparoscopic gallbladder removal to treat gallstones?

This surgery is recommended if you have pain or other symptoms from gallstones, or your gallbladder is not functioning normally. Gallstones may block the bile ducts which provide a passageway for bile to flow from the gallbladder or liver to the small intestine. This condition, known as choledocholithiasis can cause severe pain,jaundice and infection. It requires immediate medical attention. Gallstones may also block the pancreatic duct which is a tube between the pancreas and the common bile duct. This may cause pancreatitis. Pancreatitis is inflammation of the pancreas. It is a serious condition that causes severe and constant abdominal pain.