Specialty >> Gall Stone
Gallstone is the most common medical condition of the gallbladder. Lots of people from all over India seek permanent cure form gallstones. Even though, it is not an immediate life threatening disease, untreated gallstones cause lots of discomfort and pain. Thus, availing a reliable treatment is advised.
The gallbladder is a hollow, pear shaped organ, situated in the right side on the abdomen, under the liver. It primarily stores and concentrates the bile juice, which is a digestive enzyme secreted by the liver. As the name suggests, the bile helps in digestion, namely by breaking down the fat.
Gallstones are small, hard, solid concentrated particles that deposits in the gallbladder. The excess component of bilirubin and cholesterol, present in the bile leads to the formation of the gallstones. This mainly occurs when the stored bile crystalizes.
Gallstones can occur either as a larger stone or as a few in smaller size. Their size varies from a grain of sand to a small pebble to a golf ball. Often it goes unnoticed, unless it starts accumulating more and more mass and causes pain and discomfort.
Based on its composition, gallbladder stones are classified as three types-
- Cholesterol stones- These are made up of 80 percent cholesterol and vary in color from light yellow, dark green brown or white. These are usually oval in size and accounts for about 50 to 90 percent of overall gallstones.
- Bilirubin stones- These are made up of calcium salt and bilirubin component present in the bile. They have less than 20 percent of cholesterol and are usually black in pigmentation. They are usually small in size and accounts for about 5 to 30 percent of overall gallstones.
- Mixed stones- there are made up of about 20 to 70 percent cholesterol along with calcium carbonate, bilirubin, palmitate phosphate and other bile components. Due to high calcium content, they are often visible under radiograph and account for about 4 to 20 percent of overall gallstones.
The following risk factors increase the chances of having gallstones;
- Being obese
- Being pregnant
- Taking birth control pills
- Having hormone replacement therapy
- Being a woman after menopause
- Having diabetes
- Losing too much weight rapidly
- Being on repeated fasting
Often the gallstones do not inhibit any symptoms in the early stages. In some cases, it does not show off even after a decade or so. Some of the common symptoms of the same are-
- Persistent pain in the upper belly and back lasting several hours
- Vomiting
- Nausea
- Indigestion
- Bloating
- Heartburn
- Excessive gas
A possible gallstone is first rules out for probable infection and obstruction by a blood test. Upon its confirmation, either of the several other tests is recommended by the doctor. These are namely,
- Ultrasonography
- CT scan
- Magnetic resonance cholangiopancreatography (MRCP)
- Endoscopic ultrasound
- Cholescintigraphy (HIDA scan)
- Endoscopic retrograde cholangiopancreatography (ERCP)
Several patients choose not to undergo surgery for gallstones. For them, the gallstones are dissolved by certain oral medicines. But in order for it to be effective, it must be consumed for several years at a stretch. It remains effective as long the medicine continues and the gallstones recur as soon as it is discontinued.
Gallstones can also be broken down by shock wave lithotripsy, which used concentrated ultrasound to break the stones into pieces and then left to pass out of the body through the excretion system. This treatment option works only when there are fewer number of gallstones.
The surgical removal of the gallbladder is called the cholecystectomy. It is the most effective way to remove all the gallstone and mitigate its recurrence. Some of the people living without a gallbladder may encounter some discomfort, while the majority of the population does fine. The surgery is done by making an incision in the abdomen, below the lower rib.
The gallbladder is then removed along with the gallstones and the nearby areas are also checked for any stuck gallstone.
Importance of laparoscopic cholecystectomy
The laparoscopic cholecystectomy was introduced in the year 1980s. Since then, most of the procedures are being carried out in this approach. Because gallbladder is a small organ, it is much beneficial to perform this surgery with the laparoscopic approach. It offers several additional benefits over the traditional approach.
With the help of laparoscopy, the nearby organs are also examined for any possible damage. Furthermore, the exact location of each gallstone is traced with the help of cholangiogram, and ensures every gallstone gets removed from the body. Thus, the laparoscopic surgery yields as successful results as the open surgery and more.
Gastro Laparoscopy
