24 04 2023
The formation of gallbladder stones is due to the deposition of cholesterol crystals in the gallbladder. It is one of the most common digestive system disorders. Several risk factors are associated with gallstones, including female sex, obesity, reduced physical activity, hyperlipidaemia, type 2 diabetes, use of oestrogen and oral contraceptives, fatty liver, genetic predisposition, bilirubin metabolism disorder, and liver cirrhosis.
The common symptoms of gallstones are pain under the right rib cage and in the stomach area, nausea, vomiting, fever, abdominal tenderness under the right rib cage, and loss of appetite. The inflammation caused by the presence of stones in the gallbladder can be acute or chronic.
The diagnosis of gallstones can be made based on several factors including a clinical examination, laboratory blood tests such as complete blood count, leukocyte formula, hepatogram, and imaging studies like abdominal ultrasound or scanner. In some cases, an X-ray of the lungs or abdomen may show shadows of large gallstones.
The only curative treatment for gallstones is surgery, specifically cholecystectomy or the complete removal of the gallbladder with stones. This operation can be performed using laparoscopic or open surgical techniques, the latter being reserved for cases where laparoscopic surgery is not feasible. It is standard practice to send each removed gallbladder for a pathohistological examination.
The primary goal of the operation is to permanently alleviate symptoms and prevent complications such as inflammation, the presence of stones in the common bile duct, or inflammation of the pancreas while ensuring the patient can return home and resume normal activities as soon as possible. The average duration of the procedure is approximately 60 minutes, with minor variations.
The surgical procedure may be accompanied by complications such as infection, bleeding, and injury to bile ducts or other organs. After surgery, the patient can resume food intake and oral therapy after 12-24 hours.
The sutures are removed after 7 days, and the dressing of the operative wounds is only necessary once or twice. A dietary regime like the preoperative one is recommended for 4-6 weeks post-surgery. Regular check-ups, including abdominal ultrasound and laboratory tests, are advised one month after surgery (abdominal ultrasound, laboratory analyses).
In the early stages following surgery, if the patient experiences any symptoms such as fever, chills, shivering, pain, nausea, vomiting, difficulty breathing, choking, discharge from any surgical incision or swelling of the abdomen, it is important to promptly seek a follow-up examination to assess the situation.
