Overview

Gallstones or Gall bladder stones are hardened deposits of digestive fluid in the gallbladder. The gallbladder is a small, pear-shaped organ located on the right side of the abdomen, just beneath the liver. The gallbladder stores bile, a digestive fluid that is released into the small intestine.

Gallstones can be as small as a grain of sand or as large as a golf ball in size. Some people develop one gallstone at a time, while others develop several gallstones at the same time. Gallstones that cause symptoms usually require gallbladder removal surgery. Gallstones that do not cause any symptoms usually do not require treatment.

What are the causes of Gallbladder stones?

• Overweight people are more likely to develop gallstones.
• Excess estrogen from multiple pregnancies, hormone replacement therapy, or birth control pills can raise cholesterol levels in bile, slow gallbladder emptying, and result in gallstones.
• Gallstones can form in people who have biliary infections.
• People who have hereditary blood disorders, such as sickle cell anaemia, are more likely to develop pigment stones.
• Excessive dieting and the use of certain cholesterol-lowering medications can also raise the risk of gallstone formation.

What are symptoms of Gallbladder stones?

Gallstones may not show any signs or symptoms. If a gallstone becomes lodged in a duct and causes a blockage, the following signs and symptoms may occur:

• Sudden and rapidly worsening pain in the upper right quadrant of your abdomen
• Sudden and rapidly worsening pain in the centre of your abdomen, just below your breastbone
• Back pain between the shoulder blades
• Right shoulder pain
• Vomiting or nausea

Types of Gallstones or Gallbladder:

Gallstones that can form in the gallbladder include:

Cholesterol gallstones - The most common type of gallstone, known as a cholesterol gallstone, is often yellow in colour. These gallstones are mostly made up of undissolved cholesterol, but they may also contain other substances.

Pigment gallstones - When your bile contains too much bilirubin, these dark brown or black stones form.

Risk factors of gallstones:

• Women are more vulnerable than men.
• People in their thirties and forties
• Men and women who are overweight
• People who have lost a lot of weight in a short period of time
• Pregnant women, women on hormone therapy, and long-term users of birth control pills
• Consuming a high-fat diet
• Consumption of a high-cholesterol diet
• Consuming a low-fiber diet
• Having a history of gallstones in one's family
• Diabetic condition
• Having a blood disorder like sickle cell anaemia or leukaemia
• Rapidly losing weight
• Using estrogen-containing medications, such as oral contraceptives or hormone therapy drugs
• Being sick with liver disease

Complications caused by gallbladder stones:

Gallbladder inflammation - A gallstone that becomes lodged in the gallbladder's neck can cause gallbladder inflammation (cholecystitis). Cholecystitis can cause excruciating pain and a high fever.

Common bile duct obstruction - Gallstones can clog the ducts that carry bile from your gallbladder or liver to your small intestine. Severe pain, jaundice, and bile duct infection are possible outcomes.

The pancreatic duct is obstructed - The pancreatic duct is a tube that connects the pancreas to the common bile duct just before it enters the duodenum. The pancreatic duct transports pancreatic juices, which aid digestion.

A gallstone can cause a blockage in the pancreatic duct, resulting in pancreatic inflammation (pancreatitis). Pancreatitis is characterised by severe, constant abdominal pain and usually necessitates hospitalisation.

Cancer of the gallbladder - People who have a history of gallstones are more likely to develop gallbladder cancer. However, gallbladder cancer is extremely rare, so even though the risk of cancer is increased, the likelihood of gallbladder cancer remains extremely low.

Diagnosis of gallbladder stone or gallstones:

The following tests and procedures are used to diagnose gallstones and gallstone complications:

Ultrasound of the abdomen. This is the most commonly used test for detecting gallstones. Abdominal ultrasound is performed by moving a device (transducer) across your stomach. The transducer transmits signals to a computer, which generates images of the structures in your abdomen.

Blood tests are performed - LFT, CBC,  Coagulation profile and some other blood tests may reveal infection, jaundice, pancreatitis, or other gallstone-related complications.

Endoscopic ultrasound (EUS) - This procedure can aid in the detection of smaller stones that an abdominal ultrasound may miss. During EUS, your doctor will insert a thin, flexible tube (endoscope) into your mouth and digestive tract. In the tube, a small ultrasound device (transducer) generates sound waves that create a precise image of the surrounding tissue.

Some other imaging tests - Oral cholecystography, a hepatobiliary iminodiacetic acid (HIDA) scan, computerised tomography (CT), magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP) may be performed as additional tests (ERCP). Gallstones discovered during an ERCP procedure can be removed.

Gallbladder stones or Gallstones treatment:

Cholecystectomy, or gallbladder removal surgery, is one of the most common operations performed on adults in India. Because the gallbladder isn't a necessary organ, you can live a healthy life without it.

Cholecystectomy can be of two types:

Laparoscopic cholecystectomy- This is a common procedure that requires general anaesthesia. In most cases, the surgeon will make three or four incisions in your abdomen. They'll then carefully remove your gallbladder after inserting a small, lighted device into one of the incisions to check for stones. If there are no complications, you can usually go home the same day or the next day.

Open cholecystectomy - When the gallbladder is inflamed, infected, or scarred, this surgery is usually performed. This surgery may also be performed if complications arise during a laparoscopic cholecystectomy.

Non-surgical approaches for gallbladder stone – Medication can also be used to treat gallbladders tones, especially for those older patients who are not fit for anaesthesia and surgery. However, it may take months or years of treatment to dissolve your gallstones in this manner, and if treatment is discontinued, gallstones will most likely form again.

What are the advantages/benefits of Laparoscopic cholecystectomy?

Laparoscopy has gained widespread acceptance in surgical approaches to abdominal wall hernias, as well as intestinal and solid organ resection. No other operation, however, has been as profoundly influenced by the advent of laparoscopy as cholecystectomy. In fact, laparoscopic cholecystectomy (LC) has clearly replaced open gallbladder removal as the procedure of choice for routine gallbladder removal. The benefits of this approach include less scarring, less incisional pain, a shorter hospital stay, and faster functional recovery.

Aakash Healthcare, Dwarka Delhi is considered one of the best gallbladder stone surgery hospitals in Delhi.

Post operative instructions:-

• The patient is kept under observation for a few hours before being transferred to the room.
• On the day of surgery, the patient is permitted to drink oral liquids.
• The patient is allowed to move around as soon as possible after surgery.
• Depending on the clinical condition, the patient is usually discharged the same or next day after surgery.
• Waterproof dressings are applied to the port sites, and the patient is free to bathe when he or she is ready.
• The patient is advised to return in 5 days after the dressings have been removed. On discharge, the patient is given a discharge summary that includes the recommended medication as well as the date of the first follow-up appointment.
• A 24-hour helpline is available for any questions or emergencies.

Diet post surgery:

• When you get home from your surgery, you can resume your normal diet. You may want to avoid heavy foods after your surgery and only drink liquids that day.
• You may eat whatever you want the day after your surgery. For the first two weeks after surgery, you should avoid eating fatty foods. You should abstain from carbonated beverages for a few days.

Exercise post Laparoscopic cholecystectomy or gallbladder stone removal surgery:

Laparoscopic surgery recovery is much faster, and exercise can be resumed sooner. For the first 24 to 48 hours, avoid vigorous exercise. Walking, on the other hand, is essential during this time, and you should get up and walk as much as you can. Begin slowly and gradually increase your activity level in accordance with your body's needs. Generally, you should avoid heavy activity for three to five days, but this varies depending on the individual and their underlying fitness. Wait until your follow-up appointment, which should be seven to fourteen days after your surgery, before returning to your normal pre-surgery routine.

Book an appointment today with the best gall bladder specialists at Aakash Healthcare super speciality hospital, Dwarka Delhi.