The gallbladder is a small pouch which is situated under the liver and stores bile produced by the liver. This bile is then secreted through the bile duct after every meal to help with fat digestion in the intestine.  The common bile duct shares the same opening into the gut as the pancreatic duct.  Gallstones form when the bile crystallises in the gallbladder and can cause symptoms.

Image WebMD

Risk Factors

These factors increase the risk of developing gallstones

• Female
• Over the age of 40 years
• High fat diet (which is low in fibre)
• Overweight
• Sedentary lifestyle with little exercise
• Liver disease

Symptoms & Signs

Although most of the time, small gallstones do not cause symptoms, they can cause some or all of these symptoms if the stone gets stuck in the bile duct causing blockage of bile.

• Sudden pain on the right side of your abdomen
• Back pain between your shoulder blades
• Pain over your right shoulder
• Nausea or vomiting
• Fever or rigors (shivering)

Diagnosis

The gallstones can be visualised using

• Ultrasound
• MRI / CT scan

Treatment

When the gallstones cause symptoms listed above, they must be treated to prevent more serious complications such as pancreatitis, sepsis or jaundice which can damage the liver.

1. ERCP

Endoscopic Retrograde Cholangio-Pancreatography (ERCP) uses an Endoscope (introduced through your mouth) to allow the doctor to view and identify any blockages in the bile duct.  The doctor is able to inject a dye into the bile duct and take X-ray pictures to find the blockage site and stone location accurately.  These are the possible procedures which may be performed by your doctor

• Sphincterotomy (small cuts) to allow the bile and smaller stones to drain out
• Stent placement to treat strictures (narrowing of the duct) and allow the bile to flow freely again
• Removal of any bile duct stones

2. Surgery (cholecystectomy)

Surgery is required to remove the gallbladder if there are stones inside the gallbladder.  The surgery can be done using the open or endoscopic keyhole method. 

Click to view BupaUK video on Keyhole Gallbladder surgery

Post-Treatment Care

• Keep the dressing dry for the first few days
• Modify your lifestyle to a healthier one with lower fat diet, exercise and losing weight (if you are overweight)
• Try to change to a low-fat diet
• You should be able to return to your physical activities after the first week

See your doctor if you experience extreme pain, bleeding, fever,

vomiting or distended painful abdomen after the procedure

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