Biliary tract diseases
Gallstones are solid, pebble-like formations that form inside the gallbladder. Fortunately, most people with gallstones have no symptoms and do not require treatment. However, in some cases, gallstones cause pain or other complications and should usually be treated by removing all gallstones along with them.
Gall bladder
The gallbladder is a pear-shaped sac-like organ with a muscular wall, about 7.5 to 15 cm long, located on the upper right side of the abdomen, below the liver. It is connected to the liver and intestine by small tubes called bile ducts. The primary purpose of the gallbladder is to store and concentrate bile, a greenish-brown liquid produced by the liver. Bile carries waste products out of the liver, but is also essential for digesting and absorbing fatty foods and absorbing important fat-soluble vitamins. Between meals, the gallbladder relaxes and allows bile to flow into it, where it is stored and concentrated. Get off with meals.What are gallstones?
Gallstones are solid stones that form in the gallbladder. Gallstones can be as small as grains of sand or as large as the gallbladder itself. But the vast majority are smaller than 2.5 cm and are one of two main types, cholesterol or pigment. The type of gallstone is important, as cholesterol stones are more likely to respond to non-surgical treatments than pigment stones.- Cholesterol gallstones make up about 80 percent of gallstones in developed countries.
- About 20 percent of gallstones are pigment stones.
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Risk Factors for Gallstones
There are different theories about this subject. However, many people have bile with an abnormally high concentration of cholesterol and/or calcium where stones can develop. There are a number of factors that increase the risk of developing gallstones.
- Gender – Gallstones are more common in women.
- Age – The risk of gallstones increases with age. This condition is extremely rare in children and becomes increasingly common over time, especially after the age of 40.
- Family history and genetics – Gallstones are more common in some families, suggesting that genetics play a role in the development of gallstones.
- Other factors – Other conditions may increase the risk of developing gallstones, including:
- Pregnancy
- Use of estrogen-containing drugs (such as birth control pills)
- Obesity
- Fasting frequently
- Rapid weight loss (including patients with surgical weight loss treatments)
- Lack of physical activity
- Diabetes
- Sickle cell disease (and other conditions associated with the rapid destruction of red blood cells, such as in patients with mechanical heart valves)
- Cirrhosis or liver fibrosis
- Some drugs
Symptoms of gallstone disease
Silent gallstones
Most people with gallstones have no symptoms; stones remain “silent”. Silent gallstones are often found on an ultrasound or CT scan done for other reasons. Silent stones do not need to be treated, as the initial symptoms of gallstones are usually mild and there are risks associated with gallbladder removal.
If you have silent gallstones, you should be aware of the first signs of gallstone disease because you may need treatment if you develop symptoms.
Symptoms of gallstone disease silent gallstones.
Most people with gallstones have no symptoms; stones remain “silent”. Silent gallstones are often found on an ultrasound or CT scan done for other reasons. Silent stones do not need to be treated, as the initial symptoms of gallstones are usually mild and there are risks associated with gallbladder removal.
If you have silent gallstones, you should be aware of the first signs of gallstone disease because you may need treatment if you develop symptoms.
Biliary colic
Biliary colic, also known as gallstone pain or biliary pain, is the most common initial symptom of gallstones. It usually manifests as attacks of abdominal pain located in the right upper abdomen just below the lower ribs.
Sometimes it is felt in the upper center of the abdomen or even in the lower part of the chest, causing it to be confused with angina or a heart attack.
You may also experience nausea, vomiting, and pain in the right shoulder or back.
It usually occurs when the gallbladder contracts in response to a fatty meal. This compresses the stones into the gallbladder outlet, preventing it from opening. A few hours after a meal, the pain decreases as the gallbladder relaxes. In some people, the pain occurs without eating anything and often begins at or after midnight.
Once you have had your first episode of biliary colic, you are likely to experience more symptoms in the future. Such recurrent symptoms are usually more severe and are sometimes associated with complications.
Gallstone Treatment
Since patients are referred to our center from external centers, three different treatment options are generally presented to us. Each patient is unique and should be evaluated on their own. The recommendations below may vary on an individual basis. As a result of detailed examination, our patients should be managed with a joint decision.
- Expectation management: do nothing, wait and watch
- Surgical treatment: Removing the gallbladder along with the stones
- Non-surgical treatment: Trying to dissolve the stones while protecting the gallbladder
Surgical treatment
Cholecystectomy is surgery in which the gallbladder is removed along with the stones. It is one of the most frequently performed surgeries in the field of general surgery. The surgery is performed in the operating room after you have been given general anesthesia.
The gallbladder is an important organ, but you can live without it. Removal of the gallbladder usually does not cause serious complications. However, about half of people who have their gallbladder removed experience soft stools, gas, and bloating; In most people, these symptoms are mild, do not require treatment, and resolve quickly.
The surgery is usually done laparoscopically (closed technique). It is made with the help of a camera through a total of 4 incisions smaller than 1 cm in the abdominal wall. Rarely, open (classic) surgery is needed. Gallbladder surgery can also be performed by using Robotic or L.E.S.S techniques within our hospital and our team. Which technique is appropriate will be decided by interviewing the patient and after a detailed anesthesia examination.
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