Gallbladder Stone

General Definition:

Gallstones are stones that are formed in the gallbladder.

The gallbladder is a small, pear-shaped organ located below the liver in the right upper abdomen. It is a bag-like organ that is attached to the common bile duct. Therefore gallstones can sometimes move into the common bile duct.

 

Gallbladder Stones

Common Bile Duct Stone

Gallstones

Understand your problems

 

Gallstones are formed when cholesterol or bile pigments precipitate out of bile as small crystals. As these crystals enlarge, they form gallstones. Gallstones range in size from as small as a grain of sand to as large as an almond seed. The number of stones may also vary from person to person.

Certain people groups are more prone to having gallstones. These groups are easily remembered as the 4Fs:

 

  • Female – Gallstones are more common in women than men, in particularly the middle-aged females
  • Forties – It is more common amongst people who are middle-age or older. Some statistics mentioned that 3 out of every 10 persons above the age of 60 years old may have gallstones.
  • Fat – It is more common amongst people who are overweight
  • Fertile – It is more common amongst women who has previously delivered a child

Fortunately, majority of people with gallstones have no symptoms. Symptoms, when they appear, can range from mild to severe:

 

Mild symptoms:

  • Bloatedness or sensation of indigestion or fullness
  • Mild pain felt in the right upper abdomen
  • Frequent belching

 

 

Gallbladder attack:

 

This occurs when the stone rolls into and block the outlet of the gallbladder. When this happens, the patient will complain of severe pain lasting 30 minutes to several hours. This is called biliary colic. The attack may stop spontaneously should the gallstone fall back and no longer blocks the outlet. However, if the blockage persists, the patient may develop acute infection of the gallbladder (acute cholecystitis).

 

A unique feature is that symptoms tend to occur after a meal, especially after eating oily or fried food like curry or laksa.

 

Although gallstones are not usually life-threatening, there are situations where gallstones can cause complications that may lead to severe illness and even death. Such complications include acute pancreatitis, acute cholecystitis, and acute cholangitis.

 

Seek for Treatment

 

If the gallstones do not cause any symptoms, they can be left alone.

 

If you are having symptoms (as mentioned above), surgery to remove the gallbladder (cholecystectomy) is recommended. Surgery to remove the gallbladder is one of the most common operations performed on adults in the world.

 

There are 3 methods to perform this operation. While what the surgeon does inside the body is similar, the method the surgeon used to get into the body differs. These three methods are:

 

Laparoscopic Cholecystectomy (keyhole surgery)

 

  • The gallbladder is removed through 4 small cuts which will be made in your abdominal area. These cuts range in size from 5mm to 1cm.
  • Tiny clips are used to seal the blood vessels of the gallbladder and the cystic duct that connects the gallbladder to the bile duct.
  • The gallbladder together with the stones will then be extracted upon completion of operation

 

Single Incision Laparoscopic Surgery (SILS) Cholecystectomy

 

  • Remove gallbladder through a single wound about the size of 2cm made in the navel
  • Different from laparoscopic cholecystectomy : a single wound versus 4 small wounds.
  • “Scar-less operation”
  • But some studies from USA found that this method may have a higher surgical complication rate.

 

Open Cholecystectomy (traditional open surgery)

 

  • Traditional method.
  • The surgery is performed through an incision of about 10-12 cm long made in the right upper abdomen.

 

Nearly all gallbladder removal today is performed by keyhole or laparoscopic technique, known as Laparoscopic Cholecystectomy. Such minimally invasive operations result in less pain and allow the patient to recover faster. The patients typically stay only one night. Some are even discharged on the same day after operation.

 

Although laparoscopic or keyhole operation to remove the gallbladder is the standard operation nowadays, there may be special circumstances where your surgeon has to perform the traditional Open Cholecystectomy. Such situations include a severely inflamed gallbladder, infection, or scarring from other operations, etc.

 

Keen to find out more? Come talk to our surgeons, who will bring you through the problem and the treatment best suited to your condition.

 

Read More
Common Bile Duct Stones

Understand your problems

 

This problem refers to the presence of stones within the common bile duct. These stones usually come from the gallbladder. It is therefore considered a complication of gallstones. Rarely are the stones formed in the bile duct itself.

 

The stones in the common bile duct can lead to very serious consequences:

 

  • The stones can get jammed within the bile duct leading to blockage of the duct. This then lead to jaundice and injury to the liver
  • If the blocked bile duct becomes infected, this can cause a life-threatening infection called acute cholangitis
  • The stones can also block the pancreatic duct, which can lead to acute inflammation of the pancreas, called acute pancreatitis. Sometimes this can also lead to death

 

Seek for Treatment

 

Unlike the situation with gallbladder stones where surgery is recommended when patient has symptoms, for stones in the common bile duct, treatment is highly recommended even if the patient claims he has no symptoms. This is because of the potential dire consequences of common bile duct stones.

 

There are 2 main options for the removal of common bile duct stones:

Laparoscopic common bile duct exploration

LCBDE is one of the techniques to surgically remove common bile duct stones. The gallbladder is usually removed at the same time, since most of the bile duct stones originate from the gallbladder. It is a surgical operation performed through small incisions. Typically 4 small incisions are needed, similar to a laparoscopic cholecystectomy

ERCP followed by laparoscopic cholecystectomy

ERCP is a special type of endoscopic procedure which allow the doctor to remove bile duct stones. In this method, there are 2 steps to it:

 

Step 1

The patient will have to undergo an endoscopy called ERCP, during which the endoscopist will widen the bile duct opening in the small intestine (spincterotomy). The endoscopist will then attempt to remove the stone in the bile duct.

 

Step 2

If step 1 is successful, the patient then proceeds to step 2, which is an elective operation to remove the gallbladder. This is usually done by the keyhole technique called the laparoscopic cholecystectomy.

 

Step 1 and step 2 are usually performed on different days. Hence, the disadvantages of this method of treating bile duct stones are: 2 separate procedures, each with its own risks; 2 separate days, hence treatment period may be prolonged

 

 

Keen to find out more? Come talk to our surgeons, who will bring you through the problem and the treatment best suited to your condition.

 

Read More

Got any questions?

We can give you the peace of mind.