Gallbladder
Normal gallbladder function
Bile is made in the liver and secreted into the bile ducts. During rest, the sphincter of Oddi at the end of the duct is closed and bile backs up into the gallbladder. The gallbladder acts as a resevoir, or storage tank. When you eat, a hormone called CCK, or cholecystokinin, stimulates the gallbladder to contract, forcing bile down the common bile duct into the duodenum (first part of the small intestine).
Who gets gallstones?
Gallstones are usually composed of cholesterol which has precipitated from the dissolved form to the solid form. While anyone can get gallstones, certain groups of people or risk factors, may predispose patients to form gallstones. Risk factors for gallstones are:
- Females
- Obesity
- Hispanics and Native Americans
- Hormones such as oral contraceptive use and estrogen replacement therapy
- Elevated cholesterol, diabetes mellitus and metabolic syndrome
- Rapid weight loss, such as bariatric surgery
Symptoms
When stones obstruct the outlet of the gallbladder while the gallbladder contracts, pressure builds in the gallbladder causing symptoms.
Symptoms of gallstones, known as biliary colic, are epigastric or right upper quadrant abdominal pain, nausea, vomiting, and bloating. Symptoms usually occur 30-60 minutes after meals and are worse with fatty, greasy or heavy meals. Pain may radiate to the right shoulder.
Laparoscopic Cholecystectomy
Once gallstones form, they do not dissolve and usually slowly enlarge with time. The size and number of the stones is irrelevant and does not effect prognosis. The only cure for cholelithiasis is surgical removal of the gallbladder.
Surgical removal of the gallbladder, or cholecystectomy, is the most commonly performed abdominal operations. Under elective circumstances, it is usually done as an outpatient procedure with 3-4 small incisions.
