Gallbladder

Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile which is produced in the liver and is released into your small intestine in a controlled fashioned during eating.

Gallbladder

Gallbladder and bile duct

The gallbladder serves as a reservoir for bile, a yellow-green fluid produced in your liver. Bile flows from your liver into your gallbladder, where it’s held until needed during the digestion of food. When you eat, your gallbladder releases bile into the bile duct, where it’s carried to the upper part of the small intestine (duodenum) to help break down fat in food.

Gallstones and Common Bile Duct Stones:

Gallstones or Cholelithiasis involves the presence of gallstones in the gallbladder. Choledocholithiasis refers to the presence of one or more gallstones in the common bile duct (CBD). Treatment of gallstones depends on the stage of disease.

Signs and symptoms

Gallstone disease may be:

  • Asymptomatic gallstones
  • Symptomatic gallstones, characterized by episodes of biliary colic
  • Complicated cholelithiasis

Symptoms and complications result from effects occurring within the gallbladder or from stones that escape the gallbladder to lodge in the CBD. Characteristics of biliary colic include the following:

  • Sporadic and unpredictable episodes
  • Pain that is localized to the epigastrium or right upper quadrant, sometimes radiating to the right scapular tip
  • Pain that begins postprandially, is often described as intense and dull, typically lasts 1-5 hours, increases steadily over 10-20 minutes, and then gradually wanes
  • Pain that is constant; not relieved by emesis, antacids, defecation, flatus, or positional changes; and sometimes accompanied by diaphoresis, nausea, and vomiting
  • Nonspecific symptoms (eg, indigestion, dyspepsia, belching, or bloating)

Cholecystitis

Cholecystitis is inflammation of the gallbladder which occurs in approximately 20% of patients with gallstones (biliary colic) if they are left untreated. In most cases, cholecystitis is caused by gallstones that block the tube (cystic duct) leading out of your gallbladder. This results in a buildup of bile that can cause inflammation. Other causes of cholecystitis include bile duct problems and tumors.

If left untreated, cholecystitis can lead to serious complications, such as a gallbladder that becomes enlarged or ruptures. Once diagnosed, cholecystitis requires a hospital stay and treatment with antibiotics and anti-inflammatory drugs. Treatment for cholecystitis eventually includes gallbladder removal using keyhole method (laparoscopic cholecystectomy).

Signs and Symptoms

Cholecystitis signs and symptoms usually occur after a meal, particularly a large meal or a meal high in fat and may include:

  • Pain in the upper right upper quadrant of abdomen
  • Pain radiating your right shoulder or back
  • Sweating
  • Nausea
  • Vomiting
  • Fever
  • Tenderness over your abdomen when it’s touchedAbdominal bloatingChills
  • Palapable gallbladder (~30%)
  • Jaundice (<15%)

Causes

Cholecystitis occurs when your gallbladder becomes inflamed. Gallbladder inflammation can be caused by:

  • Gallstones The vast majority of cholecystitis cases are the result of gallstones that block the cystic duct — the tube through which bile flows when it leaves the gallbladder — causing bile to build up and resulting in gallbladder inflammation.
  • Tumor A tumor may prevent bile from draining out of your gallbladder properly, causing bile buildup that can lead to cholecystitis (rare).

Risk Factors

The following factors may increase your risk of cholecystitis: (5Fs – Fatty, Female, Fertile, Forty and Fifty)

  • Gallstones – Most cases of cholecystitis are linked to gallstones. If you have gallstones, you’re at high risk of developing cholecystitis.
  • Being female – Women have a greater risk of gallstones than men do. This makes women more likely to develop cholecystitis.
  • Increasing age – As you get older, your risk of gallstones increases, as does your risk of cholecystitis.

Complications

Cholecystitis can lead to a number of serious complications, including:

  • Enlarged gallbladder – If your gallbladder becomes inflamed due to bile buildup, it may stretch and swell beyond its normal size, which can cause pain and increase the risk of a tear (perforation) in your gallbladder, as well as infection and tissue death.
  • Infection within the gallbladder – If bile builds up within your gallbladder, causing cholecystitis, the bile may become infected.
  • Death of gallbladder tissue – Untreated cholecystitis can cause tissue in the gallbladder to die (gangrene), which in turn can lead to a tear in the gallbladder, or it may cause your gallbladder to burst.
  • Torn gallbladder – A tear (perforation) in your gallbladder may be caused by an enlarged or infected gallbladder that occurs as a result of cholecystitis.

Diagnosis:

Bloods

  • High White cell count usually occurs with acute cholecystitis
  • Abnormal liver function tests – may occur with acute cholecystitis
  • Amylase/lipase assays are used to assess for pancreatitis
  • Ultrasonography is the preferred initial imaging test for the diagnosis of acute cholecystitis;
  • CT is a secondary imaging test that can identify extrabiliary disorders and complications of acute cholecystitis
  • CT with intravenous (IV) contrast is useful in diagnosing acute cholecystitis in patients with nonspecific abdominal pain
  • MRI, often with IV gadolinium-based contrast medium, is also a possible secondary choice for confirming a diagnosis of acute cholecystitis and bile duct stones
  • MRI without contrast is useful for eliminating radiation exposure in pregnant women when ultrasonography has not yielded a clear diagnosis

Treatment

  • Treatment for uncomplicated gallstones require laparoscopic cholecystectomy.
  • Treatment for cholecystitis usually involves a stay in the hospital to stabilize the inflammation in your gallbladder by using antibiotics and anti-inflammatory drugs. Once your cholecystitis is under control, your doctor will recommend surgery to remove your gallbladder via keyhole surgery (laparoscopic cholecystectomy), since cholecystitis frequently recurs. If you have complications of cholecystitis, such as gangrene or perforation of your gallbladder, you may need to have surgery immediately.

Call Us Today To Explore Your Options. Gap Free Surgery Available (conditions apply) (07) 3345-6667