Gallbladder Disease

• ​​Gallbladder (gallstone) disease is reported to occur in approximately 6-9% of the population but the incidence is likely much higher than this as the vast majority of patients are asymptomatic. It is important to know that most gallstones are found incidentally and do not require an operation to remove the gallbladder. However, once a patient develops pain due to gallstones, the likelihood of that patient having further attacks of pain within two years is fairly high (approximately 67%). Surgery may be offered for these patients.

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• The classic symptoms of a gallstone attack include pain after eating. The pain typically occurs in the upper abdomen and is described as a sharp pain that comes in waves. On most occasions, the pain settles within a few minutes to hours. More seriously, patients can develop inflammation or infection of the gallbladder (termed cholecystitis) where the pain is localised to the right side of the abdomen.

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• Investigating gallstone disease in symptomatic patients usually requires a simple blood test and an abdominal ultrasound to look for stones within the gallbladder or bile duct. An ultrasound can also help determine whether or not there is inflammation within the gallbladder. The treatment for symptomatic patients is usually surgery. Today, laparoscopic ("key-hole") surgery is considered the gold standard treatment. It involves 4 small cuts in the abdominal wall. Four 'ports' are placed through these cuts to gain access to the abdominal cavity and the gallbladder. The gallbladder tube is first freed from surrounding tissue. An intraoperative Xray test is commonly performed where dye is injected into the gallbladder tube and down into the bile duct. The gallbladder is then gently cut free from the liver and removed. Some patients may even go home on the same day of surgery but most will go home the following day. Following surgery, patients will be kept on a low fat diet for a few weeks and asked to avoid any heavy lifting or straining.