What is the gallbladder?

The gallbladder is a small sac located on the right-hand side of the body, on the underside of the liver. Gall (bile) is a greenish-brown liquid which the liver produces. Gall is stored and concentrated in the gallbladder. Gall goes into the small intestine via the bile ducts to facilitate the digestion, mainly of fats. Every time we eat some gall is released into the intestines. The bile duct is a narrow tube.

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What are gallstones ?

When the chemicals in the gallbladder, cholesterol, calcium bilirubinate, and calcium carbonate are out of balance gallstones may form.

There are two main types of gallstones:

• Cholesterol gallstones – these may form if there is too much cholesterol in the bile? They are the main type of gallstones in the UK and the USA.

• Pigment gallstones- these form when the bile has too much bilirubin. They are more common among patients who have liver disease, infected bile tubes or blood disorders, such as sickle-cell anemia.

Causes :  It’s not clear what causes gallstones to form. Doctors think gallstones may result when: 

• Your bile contains too much cholesterol. Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your bile contains more cholesterol than can be dissolved, the cholesterol may form into crystals and eventually into stones. Cholesterol in your bile has no relation to the levels of cholesterol in your blood.

• Your bile contains too much bilirubin. Bilirubin is a chemical that’s produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders.

• Your gallbladder doesn’t empty correctly. If your gallbladder doesn’t empty completely or often enough, bile may become very concentrated and this contributes to the formation of gallstones.

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Treatment in India

Gallstones that do not cause symptoms (silent gallstones) do not require treatment. If gallstones do cause pain, changing the diet (for example, to a low-fat diet) does not help.

Gallstones in the Gallbladder: If gallstones cause disruptive, recurring episodes of pain, a doctor may recommend surgical removal of the gallbladder (cholecystectomy). Removal of the gallbladder prevents episodes of biliary colic yet does not affect digestion. No special dietary restrictions are required after surgery. During cholecystectomy, the doctor may also check for stones in the bile ducts.

About 90% of cholecystectomies are done using a flexible viewing tube called a laparoscope. After small incisions are made in the abdomen, the laparoscope is inserted. Surgical tools are passed through the incisions and used to remove the gallbladder. Laparoscopic cholecystectomy has lessened the discomfort after surgery, shortened the length of hospital stays, provided better cosmetic results, and reduced the time needed to recover.

The rest of cholecystectomies are done by open abdominal surgery, which requires a larger incision in the abdomen.

Gallstones Risk Factors

Experts do not for sure why gallstones develop. However, there are a number of factors that increase the risk of developing gallstones

• Sex — Gallstones are more common in women.

• Age — The risk of gallstones increases with age. The condition is extremely rare in children and becomes progressively more frequent over time, especially after age 40.

• Family history and genetics — Gallstones are more common in certain families, suggesting that genetics has a role in gallstone development.

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