Gallstones are hardened masses mostly composed of cholesterol or bilirubin formed due to an imbalance in the composition of bile stored in the gallbladder. In India, around 6-9% of adults are affected by gallstones. In the adult population, the most commonly affected age group is 40-60 years.
Sometimes, gallstones may cause no symptoms at all. These gallstones are referred to as silent stones because they do not require treatment. But in most cases, gallstones may cause problematic symptoms that call for immediate attention.
Common signs and symptoms of gallstones to watch out for:
- Pain in the upper mid-abdomen or upper right abdomen (gallbladder attack)
- Associated pain in the right shoulder
- Chest pain
- Nausea and vomiting
- Clay-colored stools
You should reach out to a gastroenterologist near you if or when you experience any of these mentioned symptoms. Gallstones will continue to cause symptoms in the majority of people until proper treatment is received.
Smaller gallstones occasionally get flushed out of the gallbladder and are excreted in the feces. A gallbladder attack can also subside on its own if the aggravating stones reposition themselves within the gallbladder. However, if the gallstones are significantly large in size, there are minute chances of the stones passing on their own without medical aid.
Getting proper medical treatment is crucial to get rid of gallstones. There are different treatment options available for gallstones- Oral and surgical treatment.
Oral medication for gallstone removal
In cases, where gallstones are small or few in number, oral medication including ursodeoxycholic acid (Actigall) may be beneficial. It typically takes approximately six months to see results and is effective in almost half of the cases. However, it is seen in some patients that stones recur once the medication is discontinued.
Thus, for severe and recurring cases of stones in the gallbladder, doctors advise surgery.
Surgical treatment for gallstones
Gallstone or gallbladder removal surgeries are safe and effective. Surgical treatment offers fast and permanent relief from gallstone disease (cholelithiasis). Surgical removal of gallstone/gallbladder is the most common treatment that provides permanent relief.
The procedure of surgical removal of the gallbladder is called a cholecystectomy. There are two techniques of cholecystectomy, traditional open surgery, and advanced laparoscopy-assisted surgery.
Laparoscopic gallbladder surgery
Nowadays, the gallbladder is removed by using the minimally invasive laparoscopic technique called keyhole surgery. The surgeon makes three to four small incisions in the abdomen during this procedure. Through one of these openings, a camera called a laparoscope is inserted into the abdomen. It enables the surgeon to monitor their actions during the operation. This ensures high precision and effectiveness.
The surgeon deflates the gallbladder by removing fluid and stones with small instruments inserted into the abdomen through other small openings. Once detached from the digestive system, the gallbladder is also removed through one of the openings. Due to the small size of the surgical incisions, patients usually recover quickly following laparoscopic surgery.
Open gallbladder surgery
In this complex surgical procedure, the surgeon makes a single incision or cut in the abdomen to remove the gallbladder. The procedure involves multiple stitches and hence the recovery period is longer. Open surgeries are conducted only in the cases where the patient has some underlying medical condition and laparoscopic technique is not suitable for them.
Why is laparoscopic treatment for gallstone removal mostly preferred over open surgery?
Laparoscopic cholecystectomy is mostly preferred over open surgery because it offers the following benefits:
- Minimal access surgery- only minor abdominal incisions are carried out
- Completes under within 30-45 minutes
- Blood loss during the procedure is minimal
- Reduced chances of injury or trauma to the surrounding tissues
- Lesser risk for bowel problems
- Shorter hospitalisation- the patient is discharged within 24-48 hours from the hospital
- Very fewer chances of pain, bleeding, and inflammation of the sutures
- Minimal chances of bowel problems following surgery such as gas, diarrhea, constipation, etc.
- No visible scars are left after complete healing from the surgery
- Do not delay gallstone treatment
Gallstones should not be left unattended for a long time or you may have to suffer serious repercussions. Gallstones that pass through the common bile duct can cause more serious medical problems than those that remain in the gallbladder. Additionally, these stones can cause pancreatitis, a painful condition caused by pancreas inflammation and several other complications.
Therefore, it is recommended that you seek timely medical advice for gallstones as soon as you start noticing the symptoms. Proper medical treatment, along with effective management practices can help you carry on with your normal routine without much problem. And if your doctor suggests undergoing surgery, do not delay the procedure. If you have any doubts, discuss in detail with your doctor and undergo the surgery at the earliest.
Though gallstones can be quite painful and troublesome, effective treatment options are easily available. Especially, if your condition is chronic, severe, or recurring, gallbladder surgery is the most effective treatment for you. Also, make sure to discuss with your surgeon regarding the minimally invasive laparoscopic treatment.