Gallstones

A gallstone is a crystalline concretion formed within the gallbladder by accretion of bile components

Classification

There are three major types of gallstones, namely cholesterol, pigmented and mixed stones.

Risk factors for gallstones:

•        Fat
•        Female
•        Fifty
•        Fertile
•        Others:
•        Hemolytic disease
•        Biliary tract infection
• 
  

Symptoms

Some patients may be asymptomatic. About 10% may become symptomatic within 5 years. Those symptoms include vague upper abdominal pain, dyspepsia and flatulence. If patients experience intense pain over right upper quadrant of abdomen, that may be the symptom of biliary colic.

Diagnosis

Diagnosis is made by clinical assessment and ultrasound examination.

Gallbladder cancer

Gallbladder cancer is a relatively uncommon cancer, most commonly seen in elderly ladies. For cases that are diagnosed early, patients can be cured by removing the gallbladder, part of the liver and associated lymph nodes. Endoscopic retrograde cholangiopancreatography (ERCP) is a common endoscopic surgery performed for such cases.

Complications of gallstones

Listed below are common complications of gallstones

•        Acute cholecystitis: this may cause empyema,
  gangrenous, perforation, peritonitis
•        Chronic cholecystitis – recurrent biliary colic
•        Cholecystointestinal fistula
•        Carcinoma – porcelain gallbladder

If gallstones migrate into the ducts of the biliary tract, the condition is referred to as choledocholithiasis, which is frequently associated with obstruction of the biliary tree. This may lead to acute ascending cholangitis, a serious infection of the bile ducts.

Gallstones within the ampulla of Vater may obstruct the exocrine system of the pancreas, which in turn can result in pancreatitis.

Either of these two conditions can be life-threatening and are therefore considered to be medical emergencies.

Gallstones Treatment

•         Surgery. Laparoscopic cholecystectomy is the standard
   treatment of gallstone disease.
•         Medical dissolution therapy
•          Extracorporeal shock wave lithrotripsy

Gallbladder polyps

Gallbladder polyps are growths or lesions resembling growths (polypoid lesions) in the wall of the gallbladder. Most polyps are benign and do not need to be removed.

However, for patients over 50 years old with polyps larger than 1 cm, they may have the gallbladder removed (cholecystectomy), especially if there are several polyps or the polyps appear to be malignant. 

Reference: psclinic.com.hk/

The information aims to provide educational purpose only. Anyone reading it should consult

Surgery Specialist before considering treatment and should not rely on the information

above.