The gall-bladdeer stone, also known as cholelithiasis, is the presence of calculus in the gall-bladder in the shape of small stones. The gall-bladder is an organ that is next to (“glued to”) the liver and works as a reservoir of bile, a substance that helps the digestion process. The bile is produced by the liver and stored in the gall-bladder, which releases de bile to the intestine/duodenum during the digestion process.

There isn’t a specific cause for the formation of the gall-bladder stones. What is known is that there is an unbalance of the bile components inside the gall-bladder, which stimulates the formation of the stones.

The gall-bladder stone is a very common disease – around 10% of the world population will have the problem at some point in life. The most affected groups by the disease are women, people over 40 years old, obese, and people who have a family history of the disease.

Symptoms

The symptoms of gall-bladder stones may be intense and serious. The most common is pain or discomfort in the upper right side area of the abdomen (similar to cramps). These pains generally start after a meal and last about two hours, generally associated to the feeling of bloating, nausea and poor digestion.Many people mistake the gall-bladder symptoms with simple digestive problems.

When the patient presents the above symptoms for more than six hours, it could be a signal that the problem may be evolving to an acute cholecystitis. In these cases, the stone obstructs the gall-bladder canal in a permanent manner, causing an acute inflammation. Besides this complication, patients with gall-bladder stones may present an acute pancreatitis. This is a serious complication, caused by the exit of a gall-bladder stone to the main canal of the bile and the pancreas, causing an inflammation in the region.

Diagnosis and Treatment

The diagnosis of the disease is done through an abdominal ultra-sound or echography. The most indicated treatment for the cholelithiasis is the removal of the gall-bladder, procedure known as cholecystectomy. Other treatments, such as the simple breaking or removal of the stones are not usually very successful.

The gall-bladder surgery used to be performed with a large incision on the abdomen, which, besides the bad aesthetic result, caused a lot of post-operatory pain. Currently, the best way to perform the surgery is through minimally invasive techniques, known as laparoscopy. In this technique, small incisions are made (“little holes”), through which the surgeon inserts a camera into the abdomen. This camera allows the visualization of the organs and the performance of the procedure with fine and delicate instruments. To create the necessary space for the use of the instruments inside the abdomen, the surgeon pumps in  carbonic gas, which is rapidly absorbed at the end of the procedure.

This surgery is a standard treatment of patients who present symptoms of gall-bladder stones. In the patients in whom the stones have been found by chance, the follow up by a specialized doctor is recommended. The age of the patient, history of diseases and amount and size of the stones are also important factors for the decision between surgery and observation.

Recovery and Complications

After the gall-bladder removal surgery, the patients do not need to follow any special diet.The bile continues to be produced in the liver and eliminated in the duodenum to help in the digestion process. The only difference is that it will not be stored in the gall-bladder any longer.

The majority of the patients stay in the hospital for only one day. Within one or two weeks, he can return to work and perform all activities, including sports. The post-operatory pain is small and the aesthetic result is very good.

As in any surgical procedure, the laparoscopic cholecisthectomy has its risks and complication, even though they are not common. The most common complications are sking infection and bleeding.Other complications, such as conversion to the conventional surgery (“incision”), lesion of the intestine or biliary tract and with anesthesia may also happen. The risks of the surgery are more common in the patients who present serious diseases or complications, such as acute cholecisititis and pancreatitis at the time the surgery is performed, or the onew who have suffered many inflamation crises.