Gallbladder Stone And Its Treatment

1. Diet rich in fatty acids.
2. Conditions where gall bladders does not empty itself totally.
3. Rapid weight loss / Post Bariatric Surgery.
4. Pregnancy or post pregnancy status secondary to cholestasis (due to hormonal effects).
5. Post cardiac procedure in: Cardiac bypass, Valve replacement etc.

1. Mixed (Most common variety)
2. Cholesterol stones
3. Pigment stones

1. Acidity symptoms
2. Pain abdomen, Rt shoulder, back
3. Vomiting, fever
4. Silent stones: stones not causing any symptoms 
5. Repeat in similar episodes 
6. Pain is the most common symptom. Most people experience of pain lasts 10-15 minutes to several times in a few hours. 
7. Gall stone can  cause Acute Cholecystitis it  is a more serious condition as the GB is actually inflamed. It happens when a stone blocks the Cystic duct leading to increased pressure inside gallbladder. This requires admission to hospital antibiotics and also urgent surgery. 
8. Stones that pass out of GB into the common Bile duct can cause complete/ partial blockage leading onto fever with chills, pancreatitis, jaundice etc.

1. Produced in the liver tissue in an enzyme which helps break down fat during digestion process. 
2. This is temporarily stored in gallbladder and signalled to empty as soon as the meal reaches the small intestine where it acts as a detergent to mix the water and fat in food for digesting.

Healthy weight through exercise and a balanced diet will significantly reduce chances of formation, although gallstone formation cannot be prevented.

• 1. Women > Men
  2. Age > 40
  3. Family members having gallstones
  4. Overweight/ obesity
  5. Rapid weight loss in short duration 
  6. Diabetes Mellitus
  7. Inflammatory Bowel disease 
  8. Previous cardiac surgeries, blood disorders
  9. Medications

Children are not as commonly affected as adults. Difficulty in diagnosing as its challenging to identify symptoms.

1. Ultrasound Abdomen: MC performed test and high accuracy. 
2. MRCP used to diagnosed common bile duct stones.
3. EUS or Endoscopic Ultrasound.

ERCP or Endoscopic Retrograde cholangiopancreatography (It is used to diagnose as well as remove the stones in common bile duet

1. Silent stones can be left alone but should be regularly followed up. Seen in a small minority of all patients. 
2. Symptomatic Gall stones (>90%) vast majority of patients are treated by removal of gall bladder surgically this is called as cholecystectomy.
3. If stones have a slipped into common bile duct then ERCP is done to remove them. All patients and common bile duct stone need to be followed up by cholecystectomy.
4. Medications such as Ursodeoxycholic acid have a role in prevention of formation of stone in patients with rapid weight loss has but seldom effective in dissolution of existing stone ,(as MC stone type is mixed in nature)

Laparoscopic cholecystectomy (key-hole surgery): 

Four small cuts made into abdomen and camera with laparoscope inserted and image viewed on a monitor and removal of gallbladder is done using special surgical instruments. 

Usually done under GA which means you will be unconscious during the procedure. Takes approximately 60-90 minutes and discharge is done in 24hrs usually.

      1.SILS (Single incision laparoscopic surgery)

       2.Open surgery: Cut near the Rt rib cage approx 12-15 cm

1. Having severe inflammation of gallbladder 
2. Difficulties during laparoscopic procedure 
3. Having breathing and heart issues of severe nature
4. Suspicion of gallbladder cancer
5. Liver conditions , scarred abdomen, bleeding disorders etc

1. Inflammation of gallbladder ( Acute Cholecystitis)
2. Severe infection leading onto Pus in GB (EMPYEMA)
3. Chronic obstruction of GB outlet leading to MUCOCELE 
4. Severe infection leading onto Abdominal infection (PERITONTIS)
5. Death of GB tissue (Gangrenous Cholecystitis)
6. Jaundice
7. Infection of Bile Duets (Acute Cholangitis)
8. Acute Pancreatitis and associated complications
9. Gallbladder cancer

1. Symptomatic gallstone: If laparoscopic cholelithiasis is performed and without any complications then patients will get back home in twenty-four hours. 
2. If complications are seen: open surgery, ERCP, management of complication takes at least 3-5 days on an average.. 
3. Post laparoscopic surgery normal activities can be started right away and in 2-3 weeks all activities can be resumed. 
4. Open surgery can lead to prolonged recovery and varies according to managed complications .