What are Gallstones?
Gallstones are solid stones that occur within the gallbladder. Gallstones can range in size and number. Most commonly, multiple small gallstones measuring about 0.5 cm will be present within the gallbladder. However occasionally there can be either one very large gallstone present measuring up to 5 cm diameter or hundreds of smaller stones the size of grains of sand.
What Causes them?
Gallstones can occur when there is an abnormality in the constituents of the bile. If there is too much cholesterol then a cholesterol type of stone can form. If there is too much bile salt then a bile stone will form. However in most cases there is no obvious cause for stone formation, although there may be a family tendency for gallstones.
Are they Common?
Gallstones occur in approximately 5% of the population. The vast majority of people with gallstones do not realise that they have them until either they have a scan, in which they show up as an incidental finding, or they develop symptoms from the gallstones.
What Symptoms do they Cause?
Gallstones can cause a number of symptoms ranging from pain, to fever and jaundice.
The most common type pf pain experienced with gallstones is called biliary colic. This typically will come on within about half an hour of eating a meal. The pain tends to be worse after a fatty or oily meal. A patient will describe a presence of a griping or colicky pain in the right upper part of the abdomen just below the ribcage. Pain lasts for up to several hours before resolving on its own.
The second type of pain than can be caused by gallstones is due to cholecystitis. This occurs when the gallstones cause an inflammation in the wall of the gallbladder. The pain is therefore more inflammatory in nature and a person will feel very uncomfortable on moving. The pain is typically in the area below the right ribcage. It is commonly associated with sweats and fevers. This pain can last several days. Often it will require a course of antibiotics or even a hospital admission.
Gallstones can also cause jaundice and pancreatitis, serious medical conditions requiring hospital treatment.
Do Gallstones Always Cause Symptoms?
5% of the population have gallstones of which 10-20% of these patients will become symptomatic. Therefore, the majority of people with gallstones never experience any symptoms. If you have been diagnosed with gallstones but have never noticed any symptoms from them, then it is reasonable to delay surgery to remove them.
What Does Gallstone Surgery Involve?
The procedure of laparoscopic cholecystectomy or removal of the gallbladder by keyhole surgery involves a short operation under general anaesthetic. The procedure will take from half an hour to an hour. It is performed via four small cuts measuring between 5 mm and 10 mm long. The gallbladder is removed along with the gallstones in a retrieval bag. The wounds are sutured and the patient will go home either on the same day or the morning after surgery. Pain is not normally a major issue and patients are comfortable and mobile following surgery because there have been no big incisions made in the abdomen. Patients can resume working within 1-2 weeks of surgery.