The gall bladder is a pear-shaped organ located beneath the liver in the right upper abdomen. It stores bile, which is carried from the liver to the gall bladder and then to the intestine to aid in digestion. The gall bladder is not essential for good health.
Gallstones form in the gall bladder due to excessive cholesterol in bile. They are primarily composed of cholesterol (fat), bilirubin (bile pigment), calcium, and small amounts of protein and other materials. Non-cholesterol stones may be black or brown pigment stones. Only 15% of gallstones are visible on abdominal X-ray, with sonography being the most common diagnostic method.
Risk factors for gallstone formation include:
Common symptoms of gallstones include:
Blood tests are typically normal for uncomplicated gallstones but are used to diagnose complications. Only 15% of gallstones can be detected via X-ray, while ultrasound (USG) is 96% sensitive. CT scans may be performed if gall bladder cancer is suspected. MRCP is used in patients unlikely to receive therapeutic intervention, and ERCP is used to diagnose and treat stones in the bile duct.
Historically, open abdominal surgery was the standard method, requiring 6-8 days of hospital stay and a large incision. However, laparoscopic surgery has made it possible to remove the gall bladder through a tiny incision at the navel. For small stones, a long course of drug therapy may be used, but this may not offer a permanent solution.
Laparoscopic cholecystectomy is a minimally invasive surgery performed under general anaesthesia. A small incision is made at the navel, and a thin tube with a camera is inserted. The abdomen is inflated with CO2 to provide a clear view, and tiny instruments are used to safely remove the gall bladder and stones.
You should provide a complete list of medications and any allergies. Inform your doctor of any heart, lung, or other medical conditions. Avoid eating or drinking 6-8 hours before surgery. Surgery will be done on an inpatient basis, and you may need to arrive the morning of surgery or the day before.
The procedure will be performed under general anaesthesia to keep you comfortable and relaxed. Your vital signs, including blood pressure, pulse, and oxygen levels, will be monitored throughout the surgery. The surgery typically lasts 45 minutes to an hour, and small bandages will be applied at the incision sites.
After surgery, you will be moved to the recovery room, where you will remain drowsy due to the anaesthesia. Once you are alert, you will be transferred to your room, and the surgeon will provide post-operative care instructions regarding diet and activity.
After the cholecystectomy, you will be kept fasting for at least 6 hours. Depending on the severity of inflammation, fasting may be extended. Once oral intake is resumed, and bowel movements are normal, you will be cleared for a full diet and discharged within 36-48 hours.
Although rare, complications can include nausea, vomiting, bile duct or vessel injury, and injury to the intestine. If the gall bladder cannot be safely removed, open surgery may be necessary. Our complication rate is less than 1% in the last 100 gall bladder surgeries.
Unlike kidney stones, gallstones cannot be treated with shockwave therapy. Techniques to break stones into fragments can cause dangerous complications, such as the stones entering the common bile duct and causing pancreatitis.
After 10 days, you may resume a normal diet, including fatty foods and alcohol.
If left untreated, gallstones can cause serious complications, such as infections, enlargement of the gall bladder, obstructive jaundice, and pancreatitis.
Laparoscopic surgeries require specialized equipment and training. They should be performed at centres with experienced surgeons and advanced instruments.
Gall bladder removal is necessary as the problem lies within the organ. The surgery, whether open or laparoscopic, will not affect your diet, lifestyle, or future prognosis.