Gall Stones

Gall Bladder is a pear shaped organ situated on the right upper abdomen, attached to the liver. The main function of the Gall Bladder is the temporary storage of bile and its release in to the duodenum via bile ducts. Bile aids in the digestion of the food.

Gall Stones is formation of hardened deposits with in the gall bladder.

Causes of formation of Gall Stones:

What leads to formation of the gall stones is not clearly understood but the proposed theory is:

• The gall bladder does not empty correctly (Gall Bladder loses its function)
• Too much cholesterol in the bile
• Too much bilirubin in the bile

(normally there is a balance between the concentration of cholesterol and bilirubin in the bile which helps to maintain these two in a soluble form, any alteration in the balance between the two will result into formation of insoluble deposits which coalesce to form gall stones)

Types of gall stones:

• Cholesterol stones
• Bile pigment stones

Depending upon the component which is more concentrated in the bile.

Risk factors for the formation of gall stones:

• Female gender
• Age above 40 years
• Obesity
• Pregnancy
• Sedentary life style
• Eating diet rich in fat and cholesterol and low in fiber
• Family history of gall stones
• Diabetes
• Losing weight very quickly
• Medicine intake such as oral contraceptives

Symptoms of Gall Stone disease:

Gall stones may be silently present with no symptoms being caused which are picked up on routine tests/ tests done for some other indications.

Gall stones usually produce symptoms when the stone blocks the duct and causing its blockage. This results in –

• Sudden onset pain in the right upper abdomen or center of the abdomen
• The pain usually radiates to the back and over the shoulders
• Sometimes the pain may mimic a heart attack and results into panic
• Nausea and vomiting may also be present

Complications of the Gall Stone disease: 

• A gall stone that blocks the outlet of the gall bladder results into an acute inflammation of the gall bladder called acute Cholecystitis.
• Acute Cholecystitis may get complicated and results into formation of pus in the gall bladder called as Empyema Gall Bladder. This pus contained gall bladder may burst open to cause gall bladder perforation. In severe form may result into gangrenous gall bladder especially in diabetic patients.
• Gall stone when blocks the common bile duct results in jaundice associated with backflow of the bile in the liver and into blood stream.
• Stone dislodgment in the ampulla results in Pancreatitis which can be life threatening
• Long standing gall stones have also been linked to formation of gall bladder cancer

Diagnostic Tests for Gall Stones: 

• Blood investigations –Complete blood counts, liver function tests
• Ultrasound Abdomen
• Magnetic Resonance Chongio-Pancreaticography (MRCP)
• Endoscopic ReterogradeChongio-Pancreaticography (ERCP)
• Endoscopic Ultrasound (EUS)

Treatment of Gall Stones:

Laparoscopic Cholecystectomy is the procedure done for the treatment of Gall Stones. Gall bladder along with the containing stones is removed through the key hole incisions.

The postoperative course is usually smooth. Patient is usually discharged with in 24 hours after the surgery without any dietary or activity restrictions.

In our practice usually there are no stiches or dressings to be done.