The gallbladder is a small, pear-shaped organ that is located just below the liver. The main function of the gallbladder is to store bile, a yellowish or greenish fluid, which is produced by the liver.
Bile, composed of bile salts, electrolytes, cholesterol, biliary pigments, etc.; It is used by the body so that vitamins and fats can be absorbed more easily by the body.
The vesicle works in the following way:
- Everything begins at the moment when the food reaches the small intestine.
- Leading to the contraction of the gallbladder and the opening of the so-called “sphincter of Oddi”, which allows the bile to move through it.
- Bile moves from the gallbladder to the small intestine, where it mixes with food and performs its digestive function.
However, there may be some problems in the gallbladder leading to incorrect operation of the gallbladder. Know these problems and how to solve them in the following sections.
Problems in the gallbladder
As we have been saying, the function of the gallbladder is to release a substance called bile (produced by the liver) at the time of digestion.
The bile ducts are the ones that connect the liver and the gallbladder with the intestine. Sometimes the bile ducts do not work correctly because they are blocked by gallstones, which are created when there are substances in the bile that harden.
That’s when the gallbladder starts to bother and hinder the patient’s life.
Let’s see some of the most frequent problems that affect the correct functioning of the gallbladder:
Cholelithiasis: stones in the gallbladder or gallstones
This is one of the most common problems with the gallbladder. It is the formation of small stones in the gallbladder, resulting from an abnormal accumulation of cholesterol or bilirubin. This concentration can cause:
- Inflammation of the gallbladder
- Obstruction of the exit ducts or bile ducts, and may even break the walls of the same.
Cholecystitis or inflammation due to infection
It is an inflammation of the wall of the gallbladder and subsequent infection of the same, due to an obstruction caused by gallstones in the cystic duct (a conduit that, together with the common hepatic duct forms the common bile duct, where the bile runs).
The obstruction caused by gallstones causes the vesicle juices to be retained inside the bladder and cause irritation in the walls. This irritation causes:
- Very strong and sudden pain.
- Inflammation of the gallbladder walls and growth of bacteria.
Choledocholithiasis: obstruction of the bile duct
Like cholecystitis, it is caused by an obstruction caused by gallstones, but this time in the common bile duct, which is where bile moves from the gallbladder to reach the small intestine. This duct is the main bile duct.
The presence of these calculations usually causes problems such as:
- Biliary colic
- Biliary obstruction
- Biliary pancreatitis.
- Cholangitis (infection and inflammation of the bile ducts).
Polyps in the gallbladder
A polyp is a growth that protrudes from the surface of the inner wall of the gallbladder. Some of the polyps can be formed due to the accumulation of cholesterol in the walls of the gallbladder.
Normally, specialists recommend removing the gallbladder when the polyps are larger than one centimeter, as they are more likely to be malignant.
Symptoms of gallbladder problems
Depending on the problem that occurs in the gallbladder, we may find some symptoms or others, although in some cases the symptoms do not vary from one problem to another.
Symptoms of cholelithiasis: stones in the gallbladder or gallstones
It should be noted that cholelithiasis or gallstones do not always present symptoms in the patient. Occasionally, doctors discover it during the course of other tests, such as x-rays, ultrasounds, etc. About 20% of patients with cholelithiasis have no symptoms.
In other cases, some of the symptoms that this gallbladder problem can produce, we can find:
- Biliary disease: intolerance to fatty foods, causing these flatulence, nausea and vomiting.
- Pain in the upper right part of the abdomen: it occurs when one of the stones of the gallbladder blocks one of the bile ducts. This pain usually occurs after eating copious meals or with lots of fat. It is a cramping pain, which increases and decreases its intensity.
- Jaundice (change of color of the skin and eyes to a yellowish color): this symptom does not occur very often.
- Fever and chills.
Symptoms of cholecystitis or inflammation of the gallbladder due to infection
Some of the symptoms are similar to those of cholelithiasis, although not all are the same.
- Pain in the upper right part of the abdomen: it remains constant, unlike the pain of gallstones, which increases and decreases its intensity.
- Nausea and vomiting.
- Fever: in the first hours fever occurs, which usually goes down little by little when the patient ingests antipyretic drugs. When dealing with a vesicle infection, this symptom is quite frequent.
Symptoms of choledocholithiasis: obstruction of the bile duct
The main symptoms of the presence of gallstones in the common bile duct (which, as we have already mentioned, is where bile moves from the gallbladder to reach the small intestine) are:
- Abdominal pain in the upper abdomen that can move to the right shoulder.
- Vomiting, nausea and indigestion.
- Fever and chills.
- Jaundice (yellowish color of skin and eyes).
Like cholelithiasis, it can be asymptomatic, causing only an alteration in the analytic.
Polyps in the gallbladder
Normally, the polyps in the gallbladder do not produce symptoms to the patient. Patients who present with polyps usually also have gallstones, so it is difficult to distinguish, in the case that the patient presents pain, where it comes from.
As we can see, all the problems of the gallbladder that we have commented, present more or less similar or equal symptoms in some cases, so the treatment will also be the same for all of them.
Treatment of gallbladder problems
When the problems of the gallbladder have symptoms, it is advisable that the patient undergo a surgical operation through which the gallbladder will be removed, which will eliminate the symptoms completely and will improve their quality of life.
The procedure by which the gallbladder is removed is called cholecystectomy and can be done in several ways:
Cholecystectomy through open surgery
The open cholecystectomy is the conventional method, although not the most used since it is more often the specialist makes use of the laparoscopic cholecystectomy.
In this intervention, the surgeon, after putting general anesthesia on the patient, makes an incision in the abdomen, about 15 cm, and proceeds to remove the gallbladder. The open cholecystectomy operation lasts approximately 30 to 90 minutes, depending on the complexity of each case.
After the operation and depending on the complexity of the open cholecystectomy operation, the patient will be discharged after 1 to 4 days and will reach full recovery after 4 – 6 weeks.
The laparoscopic cholecystectomy is minimally invasive surgery, whereby not make an incision large patient. The laparoscopic technique can be performed by several routes of approach, here are three of them:
- Conventional laparoscopic cholecystectomy: Three incisions are made in the abdominal area through which the laparoscope and other surgical instruments are inserted, which will allow the surgeon to remove the gallbladder without the need for open surgery.
- Laparoscopic cholecystectomy transumbilically: a single incision is made in the navel of the patient. Using a device called “single port”, the surgical tools necessary to remove the gallbladder are introduced. The gallbladder is removed through the incision made in the umbilicus. The scar will be minimal one month after the intervention.
- Laparoscopic cholecystectomy through the transvaginal route: unlike in the transumbilical route, 3 incisions are made in the transvaginal route (one in the posterior part of the vagina, another in the bottom of the umbilicus and another in the abdomen) through which a Laparoscope (device with a light source and a camera at one end that allows the surgeon to see the inside of the patient’s body on a monitor located in the operating room) through a small incision in the abdomen. For the remaining incisions, the rest of the surgical tools that allow the specialist to operate correctly are introduced.
To conclude, it must be said that the laparoscopic approach has advantages over open surgery, since the recovery times are shorter and healing is completed in about a month after the intervention.
Open or laparoscopic cholecystectomy definitively solves the symptoms produced by the pathology of the gallbladder. Surgery should be indicated as soon as possible to avoid the appearance of unwanted complications.