Victorian HepatoPancreato Biliary Surgery Group, Malvern Victoria
 
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Gallstones

  1. What are gallstones?
  2. What causes gallstones?
  3. What will I experience if I have gallstones?
  4. How is are gallstones diagnosed?
  5. How are gallstones treated?

1. What are gallstones?

  • The gallbladder and the ducts that carry bile and other digestive enzymes from the liver, gallbladder, and pancreas to the small intestine are called the biliary system

  • Gallstones form when liquid stored in the gallbladder hardens into pieces of stone-like material. The can take years to form

  • The liquid, called bile, is used to help the body digest fats

  • Bile is made in the liver, then stored in the gallbladder until the body needs to digest fat

  • The gallbladder contracts and pushes bile into a tube--called the common bile duct--that carries it to the small intestine, where it helps with digestion

  • Bile contains water, cholesterol, fats, bile salts, proteins, and bilirubin

  • If the liquid bile contains too much cholesterol, bile salts, or bilirubin, under certain conditions it can harden into stones

  • The two types of gallstones are cholesterol stones and pigment stones

  • Cholesterol stones are usually yellow-green and are made primarily of hardened cholesterol. They account for about 80 percent of gallstones

  • Pigment stones are small, dark stones made of bilirubin

  • Gallstones can be as small as a grain of sand or as large as a golf ball

  • The gallstone can block the exit of the gallbladder. This traps the bile in the gallbladder and result in an infection in the gallbladder

  • Problems can occur if the gallstone moves out of the gallbladder and blocks one of the ducts along the way to the small intestine

2. What causes gallstones?

  • Cholesterol stones form when bile contains too much cholesterol, too much bilirubin, or not enough bile salts, or when the gallbladder does not empty as it should

  • The cause of pigment stones is uncertain. They tend to develop in people who have cirrhosis, biliary tract infections, and hereditary blood disorders such as sickle cell anemia

  • It is believed that the mere presence of gallstones may cause more gallstones to develop

  • Other factors that contribute to gallstones have been identified, especially for cholesterol stones. Risk factors include obesity, diabetes, rapid weight loss and fasting

  • The disease is more common in older people and women, especially women on hormone replacement therapy or the pill

3. What will I experience if I have gallstones?

  • The majority of people with gallstones will not experience anything at all and the gallstone will form and disappear without you even knowing

  • However some people experience symptoms

  • These symptoms that may occur include steady pain in the abdomen that increases rapidly and lasts from 30 minutes to several hours. The pain may move into the back and the right shoulder. You may experience nausea and vomiting

  • Gallstone attacks often follow fatty meals, and they may occur during the night

  • There are further symptoms that you may experience if the gallstones leaves the gallbladder and gets stuck in the ducts

4. How are gallstones diagnosed?

  • Most are discovered by accident and usually left alone

  • If the doctor suspects a gallstone after completing their interview and examination, they are likely to do an ultrasound to find the gallstone. This is the most common test

  • Other tests that can be used include CT scans, ERCP and bloodtests

5. How are gallstones treated?

  • Surgery to remove the gallbladder is the most common way to treat symptomatic gallstones. This is called cholecystectomy

  • If the gallbladder becomes infected (Cholecystitis) and inflamed, antibiotics are given

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