Gallbladder diseases

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Gallbladder diseases

What are the functions of the gallbladder?

The gallbladder is an organ that accumulates the bile produced by the liver and secretes it during the person’s ingestion of food. Bile, which is produced into the duodenum, is used to process fats.

Stones in the gallbladder (cholelithiasis)

This is a fairly common disease. The incidence increases with age.

The formation of stones is accompanied by many factors. The substances contained in the gallbladder interact by way of supporting one another’s proportionality.  Occurrence of violations in this proportionality becomes the basis for disorders of the gallbladder function.   Moreover, genetic factors, various blood diseases, infections of this area, mechanical causes that affect the outflow of bile, high cholesterol level, etc. influence the occurrence of stones in the gallbladder.

Stones appearing in the gallbladder can be of different sizes and different amounts. The appearance of small stones is more risky, since, getting into the bile duct, they cause mechanical jaundice or pancreatitis. On the other hand, larger stones, putting pressure on the walls of the gallbladder, cause problems of a different nature.

Safra kesesi taşları

Risk factors that affect the formation of stones:

  • – use of oral contraceptives
  • – obesity
  • – Sudden weight loss
  • – A large number of fats in the diet
  • – Diabetes
  • – Long-term hunger strike
  • – Exclusively parenteral nutrition
  • – removal of the small intestine
  • – haemolytic cases
  • – Cirrhosis of the liver
  • – narrowing of the bile ducts (strictures, congenital cysts, pancreatitis, sclerosing cholangitis)
  • – Inflammatory disease of the liver
  • – Vagotomy
  • – Hyperlipidemia
  • – Pregnancy

Diagnostics

One of the most suitable methods of diagnostics of gallstones is the abdomen ultrasound scanning.   It differs by its easy realization and the absence of adverse effects. The probability of gallstones detection in the gall bladder is 97-98 %. The gallstones detection is only possible after the abstinence from food during 8 hours.

Symptoms of the gallstones occurrence.

The gallstones can remain undetected during many years and then suddenly show themselves together with very painful symptoms. The disease can be attended with nausea, vomiting, abdominal pain. The duration and character of pain may vary.  Sometimes the symptoms may show up during fatty food intake but sometimes they are not connected with the food intake at all.  Usually pain shows up in the upper and right parts of the abdomen, but sometimes there can be a sensation of pain in the middle part of the abdomen and shoots up the back. The pain usually lasts from 15 minutes to 4 hours. If the sensation of pain still remains after 6 hours, it may mean that there are some inflammatory processed started in the gall bladder. In this case it is necessary to immediately apply to any medical institution. Gallstones may also cause more serious consequences. If the gallstone reached the bile duct it can cause mechanical jaundice or pancreatitis.

How is the gallstone removal surgery carried out?

During the surgery the gallbladder is extracted completely. It is very important to apply the proper approach, taking into account that the gall bladder itself and the gallstones could already be extracted. Gallstone removal is not a treatment method.

The gallstone removal surgery can be carried out using the submerged surgery (laparoscopy). In case of detecting multiple commissures (multiple inflammations in the gall bladder is more common in case of previous operations) the submerged surgery can turn into the upfront one.

During the laparoscopy there are two opening made with the diameter of 5 mm, and 2 opening with the diameter of 10 mm, which means that there is no necessity to make larger opening as during the upfront surgery. Thus, when using the laparoscopic method, the postoperative period is more comfortable, the pain passes faster, the duration of stay at the hospital is reduced, the probability of infection is less.

Is it possible to experience any complications after the gallstone removal surgery?

Most patients do not experience any problems after the surgery.  However, there can particular problems occur which could influence the diet styles. During the first months after the surgery some people experience different problems with digesting fatty food. It is recommended to use a diet with low consumption of fat. Due to problems with the digestion of fats, diarrhea may occur. Most often this problem is temporary and does not require treatment. But in some people, diarrhea can last longer. In this case, a diet with a low percentage of fats is also recommended. Sometimes additional medication is required.

Foods to be avoided in the postoperative period.

Fried potatoes, other fried foods, eggs, chocolate, pizza, fatty meat, Vienna sausages, sausage, top milk, creams, fatty cheeses in the early months.

What should be done in cases where the gallstone disease is painless (asymptomatic)?  

In the absence of pain, stones in the gallbladder are usually found accidentally during routine examination. Such stones may not show up for years, with the percent rate of their appearance during the year amounting to 5%.  Despite the absence of symptoms, diabetic patients, elderly patients and patients with calcified walls of the gallbladder (porcelain walls) may be recommended a more serious surgical intervention.

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