Gallstones are usually very painful and require surgery. Symptoms of gallstones first appear with tenderness and pain in the stomach and abdomen. The main conditions that cause gallstones are definitely unhealthy diet and genetic conditions. Gallstones are diagnosed during examination and by ultrasound. People who need gallbladder stone surgery are decided according to the results of examination and ultrasound.
What is Gallbladder Stone, What Causes It?
Gallstones are formed when the bile accumulated in the gallbladder or ducts located under the liver cannot be completely discharged, and the cholesterol and pigment substances in it adhere over time, first forming bile sand and then petrifying and forming gallstones.
They can be of different sizes from a few millimeters to 3-4 cm.
- Cholesterol,
- Pigment
- They are divided into groups as mixed (cholesterol and pigment mixed) stones.
Sometimes the wall of the gallbladder becomes calcified / petrified as a result of chronic inflammation and stones, in which case the gallbladder is called a porcelain gallbladder and there is a high risk of gallbladder cancer (20-25%).
Causes of gallstones
- Overweight and Obesity.
- Genetic predisposition
- A fatty, unbalanced diet and not drinking enough water increase the risk of gallstones.
Conditions at risk for gallstone formation
- After the middle age group, i.e. over 40 years of age
- Those with a family history of gallstones
- In women and during pregnancy
- Obesity, overweight / obesity disease
- Rapid weight gain and loss
- People with diabetes (Diabetes)
- People taking certain medications (birth control pills)
- People who eat a high-fat and unhealthy diet and are sedentary
- It is more common in people with cholesterol disease.
What are the Symptoms of Gallbladder Stone?
- In many people, it may not give any symptoms and may be revealed in a coincidental ultrasound examination.
- Bloating and indigestion
- Nausea and abdominal tenderness
- Stomach tenderness, heartburn, burning, vomiting
- Pain in the right upper abdomen, under the ribs, in the right side, back and shoulder
- As in Mirizzi syndrome, it can sometimes show signs of yellowing of the skin and whites of the eyes. Here, the swollen gallbladder compresses the main duct, blocking bile passage and jaundice occurs.
How is Gallbladder Stone Diagnosed?
It is diagnosed with Ultrasound performed after a good clinical examination. Computed tomography is also important in both diagnosis and differential diagnosis.
How is gallbladder stone treatment performed?
In gallstones that do not cause symptoms and complaints, no intervention may not be required except in certain situations. The effectiveness of drugs on gallstones is limited and they can cause many side effects.
The ideal treatment is surgical laparoscopic (closed) removal of the gallbladder and stones together. It is not possible to remove only the stones because stones can form again in the gallbladder and complications may arise.
The operation is performed with a few small incisions in the abdomen under the view of a camera and special instruments. In some complicated cases, open surgery may be preferred, but the rate is low.
Recovery and return to normal life after laparoscopic (closed) surgery is faster.
What are the Complications of Gallbladder Stone?
- Inflammation of the gallbladder called cholecystitis. As a result of obstruction of the outlet duct of the sac, inflammation occurs in the wall of the sac and the sac may swell and burst.
- Pouch Hydrops: It is when the sac does not empty and swells due to obstruction. It causes a lot of pain and medications may be ineffective.
- Gallbladder gangrene and perforation. The gallbladder whose duct is blocked begins to swell and its circulation is impaired and eventually gangrene forms and if nothing is done, it is perforated, which can be life-threatening. This is a very risky situation for diabetics because they do not feel pain well.
- Main Bile Duct Obstruction / Cholestasis, If gallstones fall into the main duct or if there is stone formation in the duct, jaundice occurs as a result of obstruction in the main duct; At the same time, bile enzymes increase. When this condition is detected, ERCP should be performed and the duct should be opened.
- When Pancreatic Inflammation / Pancreatitis occurs, the pain spreads (like a belt) and can be life-threatening.
- Cancer, people with stones in the gallbladder are at risk of developing cancer. Especially in porcelain pouches.
How Does the Postoperative Process Work?
After gallbladder surgery, the patient feels relief immediately. The recovery process is faster in laparoscopic (closed) surgery. The patient can be discharged from the hospital even on the same day and can return to work in a few days.
Very fatty and heavy foods should be avoided in the postoperative diet and plenty of fluids should be taken. Additional enzymes may be given for a few weeks. No treatment is required in the following period. The patient continues his/her normal life.
Can Pregnant Women Have Gallbladder Surgery?
Pregnancy has an increasing effect on gallstones, and if they enter the bile duct, the risks are high.
Therefore, laparoscopic surgery for gallstones is recommended if the person with gallstones is not pregnant and a baby is planned.
Surgery should be performed in mandatory cases, but the risk is higher in the first 3 months and the last 3 months; the safest period is between 3-6 months.
