Explains Delhi’s Top Gallbladder Stones Surgeon Dr Amita Jain
The gallbladder is a small-sized organ that is located in the right upper quadrant of the abdomen, below the liver. Its major function is to store bile juice that helps digestion. Gallbladder stones are a medical condition wherein hardened deposits of cholesterol and bilirubin form and sometimes get lodged in the gallbladder or bile ducts.
The size of these stones may differ from the size of a golf ball to a grain of rice. Several stones might develop simultaneously. These stones could leave the gallbladder and get stuck along the way says India’s leading female laparoscopic surgeon Dr Amita Jain.
This is when an individual might feel the first instance of abdominal pain with discomfort. Interestingly, large-sized gallbladder stones generally, stay in the gallbladder and do not cause any discomfort. Depending on the size and discomfort caused, these stones could be removed surgically or via symptomatic care.
Types of gallbladder stones
- Depending on the composition, there are majorly two variants of gallbladder stones.
- Cholesterol gallstones
- Pigmented gallstones
Symptoms
Generally, gallbladder stones have no symptoms. However, if these stones lodge in your bile duct, it may lead to:
- Instant and rapidly growing pain in the upper right part of your abdomen
- Instant and rapidly increasing pain in the center of your abdomen, just below the breastbone
- Back pain between your shoulder blades
- Pain in your right shoulder
- Nausea or vomiting
When a visit to the doctor is needed?
Gallbladder stones might not show any signs or symptoms always. However, quick medical help is required if constant, searing abdominal pain, nausea, and fever form. Make a note of the symptoms and medical history. Gallbladder stones pain might last for several hours to a few minutes. If severe symptoms and inflammation such as those mentioned below occur, it is advisable to seek medical help immediately.
- Abdominal pain that lasts for multiple hours
- Fever or body chills
- Yellowish skin and eyes. This symptom might indicate jaundice.
- Dark-colored urine and light-colored stool
Causes
Researchers have not yet found the exact cause of why gallbladder stones occur. These stones may be caused by:
- Excess cholesterol in the bile
- Excess bilirubin in the blood
- Incomplete emptying of the gallbladder
The risk factors associated with gallbladder stones
Various factors might put an individual at risk of developing gallbladder stones. Some of them are:
- Hereditary
- Lifestyle
- Medical
Complications of gallbladder stones
Various complications might happen due to the formation of gallbladder stones. The most common ones are:
Acute cholangitis: This condition refers to the infection of bile ducts because of blockage. Infected bile ducts might spread bacteria in the bloodstream, forming a severe health condition called sepsis.
Acute cholecystitis: When a gallbladder stone gets logged in the gallbladder’s neck creating intense pain and discomfort, it might lead to Acute Cholecystitis. In extreme cases, the gallbladder may get ruptured or burst.
Blockage of the pancreatic duct: The pancreatic duct facilitates the movement of pancreatic juices that helps digestion. With gallbladder stones blockage, inflammation in the pancreas might occur which causes intense excruciating abdominal pain
Cancer in the gallbladder: Gallbladder stones may cause gallbladder cancer in extremely rare cases. A history of gallbladder stones may increase the risk of cancer, though it is quite rare.
Diagnostics
Your doctor may perform the following:
- A blood test to check for infections
- Abdominal ultrasound to check for gallbladder stones
- CT scan is a specialized scan that lets the doctors check for gallbladder stones.
- Magnetic Resonance Cholangiopancreatography (MRCP) uses radio waves and magnetic pulses to check the liver and gallbladder functioning.
- Cholescintigraphy (HIDA scan) it involves the use of radioactive material. This scan lets the doctors check whether the gallbladder contracts properly or not.
- Endoscopic Retrograde Cholangiopancreatography (ERCP), involves the insertion of a small tube, which will be passed through the endoscope to the biliary tree. A contrast dye then would be injected through a small tube into the ducts, after which X-rays will be done.
- Endoscopic ultrasound is a combination of ultrasound and endoscopy did to check for gallbladder stones.
Treatment procedure
Presently, there are numerous treatments for gallbladder stones. The doctor may likely remove the gallbladder through a surgical procedure. The removal of the gallbladder does not hinder the digestion process. The following are some of the surgical processes used.
- Laparoscopic cholecystectomy is the most common surgical procedure. It takes nearly 24 hours for the patient to get discharged post completing the procedure and about 2-3 days to recover fully.
- Open cholecystectomy is a slightly longer procedure that involves removing of gallbladder through larger incisions in the belly. Undergoing this process may take a few days for the patient to get discharged and about 7-10 days for a complete recovery.
Medications to dissolve gallstones: Medicines could help dissolve gallstones without surgery. However, in this manner, it might take months or years of treatment to dissolve the gallstones. Also, there are chances of the formation of gallstones again if treatment is stopped.
Medications for gallstones are not given commonly and are reserved for those who cannot undergo surgery. Some medicines may be used to dissolve cholesterol stones. They can cause mild diarrhea.
Shock wave therapy is another non-surgical procedure, that uses high-frequency sound waves to break/fragment the stones. Afterward, bile salt is given to dissolve small stone pieces. This therapy is used rarely.
Doctors might also try to remove gallstones during an ERCP test. For this procedure, the physician inserts an instrument through the endoscope to try to remove the stone.
Gallbladder stones are generally, harmless and dissolve on their own. But, they might pose to be life-threatening if these stones block any duct or cause an infection. Therefore, it is worthwhile to take preventive measures. Avoid processed food; rather, consume more fresh fruits, vegetables, legumes, grains, and nuts. Maintaining a healthy lifestyle decreases the chance of acquiring many diseases.
Dr Amita Jain is a surgeon with highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi