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• What is the Gallbladder? 
• What are gallstones?
• Symptoms of gallstones
• Hospital Diagnosis and Treatment
• Getting back to normal

What is the Gallbladder? 

A gallbladder is a pear-shaped, hollow structure attached to the undersurface of the liver on the upper right side of the abdomen. Its primary function is to store and concentrate bile, a yellow-brown digestive fluid produced by the liver. The gallbladder is a component of the biliary tract. Bile is crucial for the solubilization of dietary fats in our intestines.

What are gallstones?

Gallstones are solid, pebble-like substances, usually made of cholesterol or degraded product of hemoglobin molecules of the red blood cells (bilirubin), that form in your gallbladder. Gallstones can range in size from a grain of sand to a golf ball. The gallbladder can make a single large gallstone, hundreds of tiny stones, or a mixture of small and large stones.

Symptoms of gallstones

• Silent gallstones: most patients with gallstones have no symptoms; stones are found incidentally on abdominal imaging studies during annual health checkups with no complication.
• Gallstone-related complication happens when the stones block any part of the biliary tract with varying symptoms and severity, depending on the site of obstruction and superimposed infection.
  • Symptomatic gallstone: happens when the stones block the cystic duct (tube connecting gallbladder to bile duct). Symptoms can range from indigestion, bloating, and gassiness (dyspepsia) to severe abdominal pain at the epigastrium or right subcostal area, which sometimes radiates to the back.
  • Cholecystitis (gallbladder inflammation): If the stones block the cystic duct for an extended time, the gallbladder can become infected, causing symptoms including more severe abdominal pain, fever, nausea, and vomiting. The gallbladder and the upper abdominals become tender and sensitive when palpated.
  • Jaundice: if the stones pass from the gallbladder through the cystic duct into the bile duct, it can block the drainage of liver bile. Patients usually experience pain, and their skin and eyes can turn yellow.
  • Cholangitis (infection of the bile duct): blockage of the bile duct by a gallstone followed by an infection, could be potentially severe and life-threatening. Symptoms consisting of fever, colicky pain, jaundice, and shaking chills due to bloodstream infection are typical.
  • Pancreatitis: due to the common confluence of the distal pancreatic and the common bile duct, if the stones (usually tiny sandstones) block this common channel, it can cause pancreatic inflammation. Patients will experience severe pain in the upper abdomen, which may radiate to the back, lasting for a few days.

Individuals experiencing these symptoms should see a specialist as soon as possible, as more severe complications could occur.

Hospital Diagnosis and Treatment

An ultrasound of the abdomen can help confirm whether or not you have gallstones or gallbladder inflammation. However, in complicated cases, identification of bile duct stones or pancreatic inflammation, medical imaging, such as CT or MRI, may be needed.

After the diagnosis of gallstone-related complications, the doctor will consider surgical gallbladder removal to prevent future complications or recurrence. Nowadays,  laparoscopic cholecystectomy (gallbladder removal through key-hole surgery) is the standard surgical procedure in patients with complicated gallstones due to its minimally invasive surgical approach with faster recovery. The size of the incisions is small (0.5-1cm). The surgery is short (60-90 minutes) with fast recovery, requiring three days and two nights of hospital stay or shorter.

Getting back to normal

Your surgeon can advise you when you can return to your normal activities.

Generally speaking, after laparoscopic surgery you can:

• Eat a regular diet straight away – you can return to a regular diet even if you were advised to avoid certain foods before your operation, although you should try to have a healthy and balanced diet (read more about diet after gallbladder surgery)
• Engage in gentle exercises, such as walking – but be careful not to push yourself too hard too soon and ask your surgeon or GP for advice before resuming more strenuous exercise.
• Resume driving a car after one week – but first, ensure you can wear a seatbelt and practice an emergency stop without discomfort.