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.
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.
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