The gallbladder is a pear-shaped organ that sits just under the liver on the right upper side of the abdomen. It is a pouch that stores the bile produced by the liver at fasting. During meals, the gallbladder contracts and releases bile into the small intestine.

Role of bile

Bile is a dark green fluid produced by the liver cells (liver). It contains cholesterol, bile salts, bile pigments, calcium and mucus. The main function of bile is the digestion of fat and the neutralization of the acids.

Gallstones

The gallstones are created due to high concentration of cholesterol into the bile, which precipitates and becomes crystallized with calcium salts and other components of bile resulting in stone formation that entrapped in the gallbladder.

Cholecystitis

It occurs when bile becomes trapped in the gallbladder. The pressure in the bladder increases causing irritation. This can lead to inflammation due to infection by gut bacteria.

Symptoms of gallstones and cholecystitis

  • Pain in the right side of the abdomen, under the ribs
  • Pain that radiates to the right shoulder or back
  • Nausea and vomiting
  • Abdominal Bloating
  • Dyspeptic complaints
  • Fever
  • Jaundice (yellowing of the skin)
  • Clay colored stools
  • Dark urine (like Brandy)

Risk factors

  • Gallstones usually occur in people over 40 years
  • Women are affected more often than men
  • Pregnancy increases the risk
  • Obese people are more likely to develop gallstones

Treatment

Initial treatment of acute cholecystitis is usually conservative including bowel rest, intravenous hydration, analgesia, and intravenous antibiotics.
Surgery to remove the gallbladder is recommended after a period of 8 weeks. Laparoscopic cholecystectomy is the procedure of choice. It requires 4 small incisions in the abdomen, through which surgical instruments and a video camera are placed into the abdominal cavity. The gallbladder is detached from the liver and exits through the incision located below the navel. In a few cases that laparoscopic removal is not possible or contraindicated, the open procedure is performed with an incision made at the right upper quadrant of the abdomen.

Advantages of laparoscopic cholecystectomy

  • Small incisions
  • Less postoperative pain
  • Reduced hospital stay
  • More rapid recovery