Benign Gallbladder

What is the Gallbladder?

  • It is a pear-shaped bag situated underneath the liver. Its main role is to store bile. After eating, the gallbladder releases bile, which travels through bile ducts into the small intestine. The gallbladder is not essential for good health and its removal does not cause any impairment in digestion in most people.

 

What are gallstones? What problems can they cause?

  • Gallstones consist of bile salts and cholesterol. Gallstones may cause different problems, such as, pain, gallbladder inflammation and inflammation of the pancreas. The most common tool to diagnose gallbladder disease is an abdominal ultrasound.

 

Can't I have only my stones removed?

  • No, removing the stones only is not an option as it may not resolve the problem but may lead to serious complications.

 

What are the predisposing factors?

  • It is not quite clear why some people get gallstones and others with similar background don't. However it is known that, the majority of patients who present with gallstone disease are females, fertile, fair and around the age of 40. Obesity is also found to be an important predisposing factor

 

What are the treatment options?

  • Surgical removal of the gallbladder is the most effective treatment. It resolves the symptoms and prevents potential complications. Other treatments such as a low fat diet and medication to dissolve the stones have been tried, but failed to offer definitive treatment.

 

How is the surgery done?

  • The surgery involves the removal of the gallbladder with keyhole surgery. In medical terms it is called Laparoscopic cholecystectomy. Laparoscopic cholecystectomy is the procedure of choice. The surgery takes an average of 40 minutes. The surgeon makes four cuts one in the belly-button area to insert a tiny telescope and the other three to delicately dissect the gallbladder using special instruments. The gallbladder will then be removed through one of the openings and the incisions will be closed with absorbable stitches.

 

What are the risks of the surgery?

  • Most of the patients experience no post operative complications but potential risks are:
    General risks: wound infection and bleeding.
    Specific risks: Bile leak and damage to the common bile duct are the most serious risks. Fortunately their incidence is low (0.5%). However they are serious, hence, this surgery should be performed by expert laparoscopic biliary surgeons

 

What happens after the surgery?

  • Usually, patients are discharged home on the same day. In a few cases a longer hospital stay may be recommended. Patients can have a shower but should avoid having a bath until the wounds are fully healed, usually within one week. Gradual build up to a normal diet and normal activities is recommended. Most patients go back to work after two to three weeks. You should always seek medical advice if you experience increased pain, persistent tummy bloating, jaundice (yellowing of eyes or skin), fever or discharge from any of the wounds or swelling around them.

 

What are Gallbladder polyps? Do they need surgery?

  • They are benign growth in the gallbladder, however, they have a small risk of turning malignant. More than 3 polyps in number or polyps of more than 1 cm in diameter should be investigated further for potential consideration of a cholecystectomy.

 

What is a Porcelain Gallbladder?

  • it is a gallbladder with calcified walls. This should be removed as it carries a small risk of malignant transformation