What Are Gallstones?
Gallstones are solid deposits that form inside the gallbladder.
- They are usually made from substances such as cholesterol, bile salts, and calcium.
- Gallstones can occur at any age, but the risk generally increases with age.
- There are three commonly described types: cholesterol stones, pigment stones, and mixed stones.
- Their size can range from a few millimeters to several centimeters.
Causes and Risk Factors for Gallstones
The exact cause is not always known. Risk factors include:
- Diabetes.
- Being overweight or having obesity.
- High cholesterol levels.
- Long-term use of certain birth-control pills or hormone therapy.
- Haemolytic disorders, including thalassemia.
- Crohn's disease and ulcerative colitis.
Symptoms of Gallstones
Most people with gallstones have no symptoms.
When symptoms occur, they may include:
- Pain in the upper right side of the abdomen, which can sometimes be severe and occur repeatedly.
- Fever.
- Jaundice.
- A mass-like sensation in the upper right abdomen.
- Pancreatitis, which can cause severe abdominal pain.
- Obstructive jaundice if a stone blocks a bile duct (biliary obstruction).
Diagnosis of Gallstones
Tests may include:
- Abdominal ultrasound.
- Blood tests.
- Liver function tests.
- CT scan or MRCP in some cases.
Complications of Gallstones
Gallstones can cause:
- Severe gallbladder infection (severe cholecystitis).
- Pus inside the gallbladder (empyema gallbladder).
- Gangrene of the gallbladder.
- Rupture of the gallbladder (burst gallbladder).
- Bile duct obstruction (biliary obstruction).
- Pancreatitis (gallstone pancreatitis).
- Gallbladder cancer. The source text states that gallstones increase the risk of gallbladder cancer by about 38 times.
Treatment of Gallstones
For symptomatic or complicated gallstones, the main treatment is usually removal of the gallbladder (cholecystectomy).
1. Laparoscopic Cholecystectomy
The gallbladder, along with the stones, is removed through 4 small abdominal incisions (keyhole surgery) using a camera and surgical instruments.
2. Open Cholecystectomy
The gallbladder, along with the stones, is removed through a larger abdominal incision.
(After the gallbladder is completely removed, most people can live normally because the liver continues to produce bile. Bile simply flows directly into the intestine rather than being stored in the gallbladder.)
Prevention of Gallstones
- Maintain a healthy weight.
- Keep diabetes and cholesterol under control.
- Avoid unnecessary long-term use of birth-control pills or hormone therapy.
- Treat haemolytic disorders appropriately.
- Properly manage ulcerative colitis and Crohn's disease.
Conclusion
- Long-standing gallstones may increase the risk of gallbladder cancer.
- A gallstone can block the bile duct and cause obstructive jaundice.
- Gallstones are one of the most common causes of acute pancreatitis.
- Do not leave symptomatic or complicated gallstones untreated for a long period.