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Where is the gallbladder

The gallbladder is a small, hollow, pear-shaped pouch. It lies underneath the right side of your liver, in your upper abdomen. Gall bladder connects to the main bile duct to form the common bile duct. The gallbladder and bile ducts form your biliary tract. You may hear your doctor call this the biliary system

 

Any disease that affects the gallbladder is considered a gallbladder disease. 

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Wessex Gall Stone Clinic

At Wessex Gall Stones clinic, we deal with the following gall bladder diseases

 

  • Inflammation

Inflammation of the gallbladder is called cholecystitis. Cholecystitis can be either chronic (long-term) or acute (short-term). Chronic inflammation is the result of several acute cholecystitis attacks. 

 

  • Gallstones

Gallstones are small, hardened deposits that form in the gallbladder. These deposits can develop and go undetected for years. In fact, many people have gallstones and aren’t aware of them. They eventually cause problems, including inflammation, infection, and pain. Gallstones typically cause short-term cholecystitis.

Gallstones are usually very small, no more than a few millimeters wide. But they can grow to several centimeters. Some people develop only one gallstone, while others develop several. As the gallstones grow in size, they can begin to block the channels that lead out of the gallbladder. 

Most gallstones are formed from cholesterol found in the gallbladder’s bile. Another type of gallstone, a pigment stone, is formed from calcium bilirubinate. Calcium bilirubinate is a chemical that’s produced when your body breaks down red blood cells.

 

  • Common Bile Duct Stones (Choledocholithiasis)

Gallstones can occur in the common bile duct. The common bile duct is the channel that leads from the gallbladder to the small intestine. Bile is ejected from the gallbladder, passed through small tubes, and deposited in the common bile duct. It’s then ushered into the small intestine.

In most cases, common bile duct stones are actually gallstones that developed in the gallbladder and then migrated into the bile duct. Sometimes stones form in the common bile duct itself.

 

  • Gallbladder Disease Without Stones

Gallstones don’t cause every type of gallbladder problem. Gallbladder disease without stones, also called acalculous gallbladder disease, can occur. In this case, you may experience symptoms commonly associated with gallstones without actually having stones.

 

  • Common Bile Duct Infection

An infection may develop if the common bile duct is obstructed. Treatment for this condition is successful if it’s found early. If it’s not, the infection may spread and become fatal.

 

  • Abscess of the Gallbladder

A small percentage of patients with gallstones may also develop pus in the gallbladder. This condition is called empyema. Pus is a combination of white blood cells, bacteria, and dead tissue. The development of pus leads to severe abdominal pain. If the condition isn’t diagnosed and treated, it can become life-threatening as the infection spreads to other parts of the body.

 

  • Gallstone Ileus

A gallstone may travel into the intestine and block it. This condition is rare but can be fatal. It’s most common among individuals over age 65.

 

  • Perforated Gallbladder

If you wait too long to seek treatment, gallstones can lead to a perforated gallbladder. This is a life-threatening condition. If the tear isn’t detected, a dangerous widespread abdominal infection may develop.

 

  • Gallbladder Polyps

Polyps are growths that are typically benign, or noncancerous. Small gallbladder polyps may not need to be removed. In most cases, they don’t pose any risk to you or your gallbladder. But larger polyps may need to be surgically removed before they develop into cancer or cause problems. The decision to remove gall bladder polyps depend on its size and number. Sometimes based on patient race we may decide to remove the gall bladder, as there is a higher risk of gall bladder cancer.

 

  • Porcelain Gallbladders

A healthy gallbladder has very muscular walls. Over time, calcium deposits can stiffen gallbladder walls, making them very rigid. This condition is called porcelain gallbladder. Those with this condition have a very high risk of developing gallbladder cancer.

 

  • Gall Bladder Cancer

Early gall bladder cancer often causes no symptoms. It is usually discovered when someone has surgery to remove gallstones. About 1 in 5 gall bladder cancers (20%) are found this way.

Most gall bladder cancers are only found at an advanced stage. They can cause a variety of symptoms, including:

  • sickness

  • fevers

  • weight loss

  • pain in the tummy.

If the cancer blocks the bile duct, it may stop the flow of bile from the gall bladder into the small bowel. This causes bile to flow back into the blood and body tissues. This can lead to:

  • the skin and whites of the eyes becoming yellow (jaundice)

  • the urine becoming a dark yellow colour

  • pale stools (bowel motions)

  • itchy skin.

These symptoms may be caused by other problems, such as gallstones or an infection of the gall bladder. But it's important to get them checked by your doctor.

 

How gall bladder disease is diagnosed

Your Doctor will see you and if suspicion arises of gall bladder disease then he may ask for the following tests:

  • Ultrasound scan

You'll usually be asked not to eat or drink anything for at least six hours before the scan. Once you are lying comfortably on your back, a gel is spread onto your tummy (abdomen). A small device that produces soundwaves is then passed over the area. The soundwaves produce a picture on a computer. The test is painless and only takes a few minutes.

  • MRI (magnetic resonance imaging) scan

This test is similar to a CT scan, but it uses magnetism instead of x-rays to build up a detailed picture of areas of your body. Before the scan, you may be asked to complete and sign a checklist. This is to make sure it’s safe for you to have an MRI scan.

Before having the scan, you’ll be asked to remove any metal belongings, including jewelry. Some people are given an injection of dye into a vein in the arm. This is called a contrast medium and can help the images from the scan show up more clearly. During the test you’ll be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It's painless but can be slightly uncomfortable, and some people feel a bit claustrophobic during the scan. It’s also noisy, but you’ll be given earplugs or headphones. You will be able to hear and speak to the person operating the scanner.

  • How to treat gall bladder disease

If the gall bladder is diseased and causing symptoms, it should be removed if you are fit to have surgery under general anaesthesia. the gall bladder is usually removed by key whole surgery (Laparoscopy)

 

  • Laparoscopy

This is a small operation that allows the doctors to look at your gall bladder, liver and other internal organs in the area around the gall bladder. It’s done under a general anaesthetic and you will have a short stay in hospital.

While you are under anaesthetic, the doctor will make a small cut (incision) in your tummy (abdomen) and insert a thin, flexible tube that has a light and camera (laparoscope). They will look at your gall bladder. 

Gall Bladder is removed by key hole surgery most of the time. 

After a laparoscopy, you will have one or two stitches in your abdomen. You may have uncomfortable wind and/or shoulder pains for several days after the operation. You can often ease the pain by walking or taking sips of peppermint water. You can experience loos bowel motion for three months after surgery, this is natural body reaction to loosing the gall bladder, and it is self limiting.

 

Can the Gall stones be treated without surgery.

There are medicine to dissolve the gall stones, these are not used in clinical practice, when the patient is fit for surgical treatment. These medicines not been proven to be effective in management of symptomatic gall stones disease, and can be associated with side effects.

Therefore, the only recommended treatment for symptomatic gall stones, is to remove the gall bladder by surgery.

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