GALLBLADDER DISORDERS
WHAT IS
THE GALLBLADDER?
The gallbladder is an organ that stores bile, a fluid produced by the liver that aids in digestion. Through a network of very thin tubes (biliary system), bile is collected in the gallbladder, a pear-shaped sac located beneath the liver.
After each meal, especially those high in fat, the gallbladder contracts and sends bile through other tubes to the small intestine to facilitate food digestion. The gallbladder is commonly referred to as the “gall” in everyday language, and it is this organ that is removed during a cholecystectomy procedure.
What problems can occur in the gallbladder?
Biliary Colic
Pain in the upper right abdomen caused by a stone lodged in the gallbladder. It usually subsides easily with simple analgesics.
Acute Cholecystitis
Inflammation of the gallbladder that causes severe pain in the upper right abdomen and fever. It requires hospitalization and surgical intervention (removal of the gallbladder).
Obstructive Jaundice
A stone passes from the gallbladder into the tube that carries bile to the intestine (common bile duct), resulting in pain and intense yellowing of the patient (jaundice). Hospitalization is required until the jaundice subsides, after which the gallbladder must be removed. A magnetic resonance imaging of the area (MRCP) is always performed, and if the jaundice does not subside, the patient initially undergoes a special examination called ERCP, followed by surgery.
Pancreatitis
The pancreatic duct is obstructed by a gallstone (due to its common junction with the bile duct), causing inflammation in the pancreas that initially manifests as pain and vomiting. This condition can be very simple but also particularly serious and can even lead to death. Hospitalization and intensive medical monitoring and care are required.
WHO IS AFFECTED
Gallbladder surgery typically concerns individuals facing the following issues:
1.Gallstones
Gallstones are solid deposits that form in the bile and can cause serious complications, such as inflammation or obstruction of the bile ducts.
Surgery is recommended when stones cause severe symptoms (e.g., pain in the upper right abdomen, nausea, or vomiting).
2.Inflammation of the Gallbladder (Cholecystitis)
Gallbladder inflammation, usually caused by gallstones, can lead to serious infections and may require immediate surgical intervention to remove the organ.
3.Bile Duct Obstruction
Obstruction of the bile ducts by stones or tumors can impede the normal flow of bile, causing jaundice (yellowing of the skin and eyes), severe pain, and other complications.
4.Tumors or Polyps in the Gallbladder
In cases where tumors or polyps are detected in the gallbladder, especially if they cause symptoms or there’s a risk of cancer development.
5.Frequent or Painful Attacks
If someone suffers from frequent and intense pain attacks due to gallstones or other gallbladder problems, despite attempts at conservative treatment (e.g., diet, medications).
THE DOCTOR ADVISES
Gallstones cannot disappear on their own. However, if they are very small, they may move towards the intestine and pancreas. Gallstone disease can be temporarily managed with dietary adjustments, such as reducing fat intake. However, this treatment has limited and short-term success rates. Symptoms will eventually return unless the gallbladder is removed.
Surgical removal of the gallbladder is the safest treatment in the majority of cases. Gallbladder removal (cholecystectomy) is one of the most frequently performed surgical procedures. Nowadays, cholecystectomy is almost always performed laparoscopically (laparoscopic cholecystectomy).
PROCEDURE
CONSULTATION
THE SURGERY
RECOVERY
In addition to the patient’s history and clinical examination, the most useful diagnostic test is ultrasound. Ultrasound is an examination that provides the most important information about gallbladder disorders. In special cases, computed tomography, magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP) can be particularly useful.
The procedure is almost always performed laparoscopically.
Laparoscopic cholecystectomy is now safely performed (depending on the surgeon’s experience, of course) even in cases of severe organ inflammation, such as gangrene of the gallbladder.
In a very small percentage of patients, conversion to open surgery is required due to special conditions such as intense adhesions from previous abdominal surgeries. This percentage ranges from 1-10% depending on the surgeon’s experience in laparoscopic surgery.
The significant advantages of laparoscopic cholecystectomy (minimal surgical trauma, negligible blood loss, short hospital stay, quick recovery and rapid return to work, minimal pain, fewer complications related to the wound, fewer respiratory and cardiovascular complications, etc.) have established it as the most common laparoscopic surgical procedure.
The laparoscopic surgical procedure for gallbladder removal takes about 1 hour.
Most patients can return home even on the same day.
You should avoid lifting weights and intense physical exercise for about 1 month after the procedure.
ΠΡΙΝ
& ΜΕΤΑ
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FAQs
What is bile and what conditions are associated with it?
Bile is a fluid produced in the liver and stored in the gallbladder. Its role is to aid in food digestion.
Cholelithiasis
Cholelithiasis or gallstones is the presence of stones in the lumen of the gallbladder or extrahepatic bile ducts. It’s a common condition, affecting 10% of the population, although this varies from country to country. It’s caused by the supersaturation of bile with cholesterol or obesity and an unbalanced diet. Additionally, due to cholelithiasis, certain pathological conditions may appear in the body such as biliary colic, acute cholecystitis, and choledocholithiasis.
Gallbladder polyps
Gallbladder polyps are an abnormal growth of tissue. There are different types of polyps, with cholesterol polyps, adenomyomas, inflammatory polyps, and adenomas being the most common. Gallbladder polyps are usually not a cause for serious concern. However, in some cases, they are associated with the development of malignancy and necessitate the removal of the gallbladder to eliminate this risk.
Acute cholecystitis
This is a condition characterized by inflammation of the gallbladder due to obstruction of the cystic duct. The result is the prevention of bile drainage, leading to increased pressure in the bile. Cholecystitis is characterized by pain, fever, nausea, and vomiting. It’s divided into two types: lithiasic cholecystitis and alithiasic cholecystitis. Lithiasic cholecystitis is the most common type and is associated with cholelithiasis. In contrast, alithiasic cholecystitis is a rarer but extremely serious form. It appears more frequently in patients with diabetes mellitus and its progression can be sudden.
Are only the stones removed?
Some cases can be temporarily managed with medication or dietary treatment, such as reducing fat intake. This treatment has limited and temporary success rates. Symptoms will continue until the gallbladder is removed. Lithotripsy of stones was applied in the past but created stone fragments that caused complications in the bile duct and was abandoned as a method.
Surgical removal of the gallbladder is the most appropriate and safest treatment for cholecystitis.
How big will the wound be?
Laparoscopic cholecystectomy requires 4 small holes less than 1 centimeter each, so the wound is not large. In 5-6 days, they will have closed completely. In the case of open surgery, the incision is larger.
Is a special diet needed?
A special diet is needed, with restrictions on fat. It’s the post-cholecystectomy diet and one should avoid certain food groups and consume others. It will help balance the body in the process of digestion and fat breakdown.
Will medications be needed after surgery?
Some medications will be needed for the digestion process, so gastroprotective treatment, antibiotics, antacids, or antialkaline drugs may be needed in combination with the diet.
When can I return to my activities?
For safety reasons, return home is usually within 24 hours. Moreover, recovery after removal is immediate and consequently, the return to your daily routine and activities is very quick.
Η Κλινική
