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Gallbladder disease
Reviewed by Mr Robert Diggory, consultant general surgeon
Jaundice (yellow discolouration of the skin and whites of eyes)
This is caused when there is an obstruction to the flow of bile from the liver. Jaundice is not always caused by gallstones. The symptoms are:
What can be done at home?
Recurrent painful attacks, if mild, can be treated with over-the-counter painkillers. Placing something warm on your stomach may be helpful, taking care not to scald the skin. The frequency of attacks may be reduced by a low-fat diet.
How are gallstones diagnosed?
If you fail to do so, and you develop symptoms that require treatment while you are on holiday then any claim for reimbursement may be rejected.
How are gallstones treated?
Some people are able to manage mild symptoms with a combination of a low-fat diet and painkillers to control their abdominal discomfort.
To be suitable for dissolution therapy the gallstones have to be small to medium in size and 'radiolucent', ie they do not show up on plain X-rays. Gallstones that do show up on plain X-rays do not dissolve. The gall bladder also needs to still show the ability to contract.
Lithotripsy - single gallstones in the gall bladder or bile ducts can sometimes be 'shattered' by a technique called lithotripsy, which uses a 'beam' of sound energy. This method is commonly used for treating kidney stones but is only rarely useful for gallstones. The fragments of shattered stone will still need to be removed by ERCP or dissolution therapy.
Surgery for gallstones
If the gall bladder is left behind it is quite likely that further gall stones will form in it. There are two ways of removing the gall bladder and nowadays more than 90 per cent are removed by laparoscopic or keyhole surgery.
This involves making four small cuts less than 1cm long in the abdomen and the use of a tiny camera inserted though one of these cuts to see the gall bladder.
Other instruments are placed in the abdomen through the other cuts. If the operation is successful most patients are able to go home the day after surgery and return to normal everyday activities within two weeks.
In some cases laparoscopic surgery is considered too dangerous or too difficult and it is then necessary to do a traditional or 'open' cholecystectomy. This involves making a cut in the abdomen between 9 and 18cm long. The patient will usually need to stay in hospital for at least five days and will not be able to return to work for six to eight weeks.
Will the patient notice any difference after surgery?
Complications following gallbladder surgery are very rare and there are usually no long-term effects from having a gall bladder removed.
Gallstones which do not cause symptoms do not need any treatment. If a low-fat diet is not successful in controlling the symptoms some other form of treatment is required - this usually, but not always, means surgery.
When an operation is required for gallstones in the gall bladder it is usual to remove the gall bladder and gallstones together - this is called cholecystectomy.
After the gall bladder has been removed most people will be aware that their pain has completely disappeared and they no longer need to avoid fatty food.
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