The gallbladder is located in its special place under the liver. It stores the yellow-green colored bile produced by the liver. It helps the digestion of fats by secreting this bile into the small intestine after the meal.
Gallstone; It occurs as a result of the deterioration of the content (chemical structure) of the bile made in the liver for any reason, and its precipitation mostly in the gallbladder or bile ducts. The bile, which initially takes the form of sludge, then solidifies further and takes the form of gallstones. Gallstones almost always form in the gallbladder. Approximately 10% of patients may also have stones in the bile ducts.
There may be only one stone in the gallbladder, or there are cases where the number reaches thousands.
frequency; When you think of gallstone disease, gallstones come to mind. Gallbladder stones are a common disease in the community. Although it varies from country to country, stones in the gallbladder can be detected in 10-15% of women who are over 40 years old, obese and have given birth. Gallstones are a common disease in men, although not as much as in women. Gallstones, which occur in one out of every 10 adults, are more common in women, especially after the age of 30. After the age of 60, gallstones occur in 10-15 percent of men and 30-40 percent of women.
Gallstones are common in blonde women, overweight people, those who lose weight very quickly, those who have been fed intravenously for a long time, and those whose stomachs have been removed by surgery. There is evidence to suggest that the disease is inherited. There are publications that caffeinated beverages and alcohol reduce gallstones.
Causes: As mentioned, events that cause changes in the chemical structure of bile and its fluidity lead to stone formation. These can be listed as various infections, some blood diseases, nutritional habits. Cholesterol stones form when there is not too much cholesterol and not enough bile salt in the bile. In addition to high cholesterol, two other factors were found to be important. The first of these is how often and how much the gallbladder contracts; Infrequent and inadequate gallbladder emptying can cause bile to become too concentrated and contribute to stone formation. The second factor is the presence of certain proteins in the liver and bile that can facilitate or inhibit cholesterol crystallization.
In addition, high estrogen levels as a result of pregnancy, hormone therapy or use of birth control pills can increase cholesterol levels in bile, reduce gallbladder contraction, and as a result, gallstones may occur.
A definite link between nutrition and gallstone formation has not been demonstrated. However, it has been suggested that low-fiber, high-cholesterol diets and high-starch diets may contribute to gallstone formation.
Does genetics play a role in gallstone formation?
Yes. It is more common in some breeds, suggesting that genetic factors play a role in gallstone formation.
Findings and Diagnosis: Since gallstones disrupt the functioning and structure of the gallbladder, they cause indigestion, abdominal bloating, belching, abdominal pain, especially after meals.
Abdominal pain is more common on the right side and may radiate below the shoulder blade. Bile is a secretion that is especially necessary for digesting fatty foods. Complaints become more pronounced after such fatty meals (Chocolate, egg and oil-fried foods).
Diagnosis
Diagnosis is easily made by ultrasonography. It is usually detected while investigating another problem.
What does gallbladder inflammation mean? Inflammation of the gallbladder is considered in the case of jaundice, fever and severe abdominal pain that starts suddenly and does not go away. In patients with such complaints, stones in the gallbladder and biliary tract can be diagnosed with a device called ultrasonography. Inflammation of the gallbladder is a disease that requires immediate treatment. The gallbladder can be perforated, which can be life-threatening.
What diseases do gallstones cause?
It can cause gallbladder inflammation.
It can also cause jaundice by blocking the bile ducts.
Gallstones can also cause liver diseases such as cirrhosis.
It can inflame the pancreatic gland and lead to a disease called Pancreatitis. This is a very serious disease that requires immediate treatment and can be life-threatening.
These complications are more important in patients with diabetes and atherosclerosis (hardening of the arteries).
In general, it is unpredictable when the stones in the gallbladder will cause discomfort.
Association of Gallstones and Cancer: It has not been proven that gallstones cause cancer. However, gallbladder cancer is found in every 100 gallstone diseases.
What does jaundice with gallstones mean?
Stones in the gallbladder can cause jaundice by falling into the bile ducts and blocking the duct. Sometimes gallstones can also form in the bile ducts themselves, independently of the gallbladder. Stones smaller than half a cm in the gallbladder may fall into their channels more easily than large stones and cause problems (Small stones are more dangerous than large stones). Gallstones can cause inflammation in the bile ducts and lead to jaundice (cholangitis).
Treatment of Gallbladder Stones: There is no drug treatment for gallstones. Treatment is done by surgery. In surgery; The entire gallbladder is removed together with the stones in it (cholecystectomy surgery). Removal of the gallbladder does not cause any problems for the next life. Surgery cannot be recommended for gallstones that do not cause any complaints and are discovered incidentally during tests performed for another reason. However, in the presence of diabetes and/or small and multiple gallstones, the physician may recommend surgery, taking into account the possible risks.
How is Gallbladder Surgery Performed? It is done in two ways.
1- In the open surgery technique, the patient’s abdomen is opened and the gallbladder is removed.
2-In the closed surgery (laparoscopic technique) technique, 3-4 holes of 0.5-1 cm are drilled in the abdomen and the operation is performed with the instruments inserted from here. This method is the gold standard procedure applied all over the world for this disease.
Treatment of gallbladder stones associated with bile duct stones: Patients have jaundice or abnormality in some biochemical tests. In this case, the stones in the bile duct are successfully removed with a lighted instrument (endoscope) inserted through the mouth before or after the operation (usually before the operation).
Then, the closed surgical technique, the gallbladder is also removed.
What are the Risks of Gallbladder Surgery? Whether the gallbladder surgery is performed open or closed, there are some risks (complications) especially when performed under emergency conditions. The rate of these complications is 1-2%. In competent hands, these complication rates are very low.
Especially closed gallbladder surgeries, which are performed laparoscopically, can be performed as “day surgery” in many centers today and patients are at home in the evening of the day they are operated. With this method, the length of stay in the hospital is shortened, the costs are reduced and the return time of the patients to work is shortened. However, it is clear that this method should be performed in competent hands and in appropriate centers.
By removing the entire gallbladder, the possibility of disease recurrence, re-stone formation, cancer and complication development is eliminated. Absence of a gallbladder does not cause any serious problems in humans.”
It is not uncommon for the structure (anatomy) of the bile ducts to be highly variable and to have dozens of different anomalies. It is not possible to detect them before surgery. Therefore, the experience of the surgeon is very important.
Although the closed surgery technique is widely used, it should be performed by experienced hands.
Otherwise, the solution of complications that may occur during the operations may become more difficult than the solution of the initial disease.
Is it possible to treat with medication?
Although drug treatment in gallstones gives positive results at the beginning, the stones form again within 4 years in half of the patients. Therefore, laparoscopic gallbladder surgery is considered the gold standard in treatment.
Applications to the hospital
One-fifth of hospital admissions due to gallstones are caused by inflammation due to duct obstruction. Although gallstones do not cause cancer, stones are found in 70 percent of those who have undergone surgery for gallbladder cancer.
There is a 20-60% chance of cancer in gallbladders with porcelain or calcified stones, and surgery is recommended even if there are no complaints in these patients.
Protection
Obesity is a risk factor. People should bring it to their ideal weight. On the other hand, there is no special diet for gallstones.
Stay healthy…
