The gallbladder is a small pear-shaped sac that holds bile, a digestive juice produced by the liver that is used in the breakdown of fatty foods. The gallbladder extracts water from its store of bile until the liquid becomes highly concentrated. The presence of fatty foods triggers the gallbladder to squeeze its bile concentrate into the small intestine.
Gallstones (biliary calculi) are small stones made from cholesterol, bile pigment and calcium salts, usually in a mixture that forms in the gallbladder. They are a common disorder of the digestive system.
Some things that may cause gallstones to form include the crystallisation of excess cholesterol in bile and the failure of the gallbladder to empty completely.
In most cases, gallstones don’t cause any problems. However, prompt treatment may be needed if stones block ducts and cause complications such as infections or inflammation of the pancreas (pancreatitis).
You may need gallbladder removal surgery if you have pain or other symptoms from gallstones or if your gallbladder is not working normally.
Common symptoms may include:
- Pain after eating, usually in the upper right or upper middle area of your belly (epigastric pain)
- Nausea and vomiting
In a small number of cases, gallstones can become trapped in a duct (an opening or channel), irritate and inflame the gallbladder, or move out of the gallbladder and into other parts of the body.
This can lead to a range of symptoms, such as:
- a sudden intense pain in your abdomen
- feeling and being sick
- jaundice (yellowing of the skin and the whites of the eyes)
There are several non-surgical ways to break down gallstones, but they are only effective in around less than 1 in 10 cases and are rarely a viable option.
For most people with painful gallstones, it is recommended that their gallbladder is removed.
Laparoscopic (keyhole) cholecystectomy
With this type of operation, a tiny camera and surgical instruments are inserted through small cuts (incisions) in your abdomen. to remove the gallbladder.
In open cholecystectomy, or open surgery, the gallbladder is removed through one large incision in your abdomen. It is a more invasive operation than keyhole surgery and recovery time in longer.
Both techniques are usually carried out under a general anaesthetic, so the person having the operation is asleep during surgery and will feel no pain.
Laparoscopic gallbladder surgery is safe and effective. Laparoscopic surgery to remove stones in the common bile duct is far more challenging and should only be undertaken by surgeons trained specifically in the techniques.
The technique involves using a tiny camera called a choledochoscope to visualize and remove these stones during the laparoscopic cholecystectomy. Gallstones can form in the common bile duct years after the gallbladder is removed, although this is rare.
Below is a video of the procedure. (Warning, this video is graphic is nature.)
- Laboratory, X-ray and diagnostic procedures, and interpretation
- Laparoscopic cholecystectomy
- Laparoscopic Common Bile Duct Exploration and Stone Removal
- Use of the operating room, case room, and anaesthetic facilities required for diagnosis and treatment, including necessary equipment and supplies