How do I know if I have gallstone or gall bladder problems?
The commonest symptom is acute pain at the top of the stomach. Sometimes this can be severe. Sometimes patients may have discomfort after eating fatty or fried food. Other problems include dark urine, yellow jaundice or indigestion. Occasionally patients do not have any symptoms at all and are diagnosed after a scan done for some other reason.
How is the diagnosis made?
The majority are diagnosed following an ultrasound scan with patients often referred to me following their diagnosis.
What problems can arise due to gallstones?
While pain is commonest, there are other more serious consequences that may happen in some patients including an infection in the gall bladder and the formation of pus.
Migration of a stone from the gall bladder in the bile tube can cause jaundice and inflammation of the pancreas gland (Pancreatitis). These are very serious conditions.
What treatments are available?
Sometimes assessment, advice and reassurance is all that is needed.
Medical treatments, including tablets to dissolve gallstones or shock wave pulverisation of stones are ineffective, hazardous and are not generally recommended. The majority of cases are treated effectively by surgery.
How is this operation done?
This is done by key hole (laparoscopic or minimal access) technique and involves making 3 or 4 small holes in the belly. A high definition camera and TV monitor is used to visualise and remotely remove the gall bladder.
Why does the gall bladder need to be removed?
The gall bladder is the "factory" that manufactures the stones. Hence, both the gall bladder and the gallstones are removed. This operation is called Laparoscopic Cholecystectomy.
Is there anything special that can be done to ensure cure?
I routinely take an x-ray of the bile tube (common bile duct) to ensure no stones have escaped from the gall bladder. This is because bile duct stones are more dangerous than stones in the gall bladder. This procedure is called Intraoperative Cholangiogram.
How safe is the operation?
Major complications are extremely rare in expert hands. A small percentage (2-5%) of patients may not be suitable for key hole surgery. This is the reason patients need careful assessment by an expert as there are other rarer complications.
An assessment is needed to weigh up the benefits against the risks.
How is the expected recovery?
Normally patients stop taking painkillers within 3 to 4 days and go back to work within 10 to 14 days. Understandably recovery varies between patients