Gall bladder is a sac like organ attached with liver by bile duct. It stores bile temporarily. Bile is synthesized in liver. During empty stomach / fasting gall bladder gets distended with bile and it empties it when food (especially fatty food) reaches intestine. Due to various reasons like excessive weight (obesity), pregnancy, genetic, infection, prolonged stay in ICU bile gets concentrated and forms gall stones.
Gall stones are primarily of two types. Cholesterol and pigmented stone. Small stones can be asymptomatic initially and at times of gall bladder emptying may slip inside bile duct resulting surgical obstructive jaundice. It is a surgical emergency and may require clearance of bile duct (ERCP) followed by gall bladder removal. Whereas bigger stone causes recurrent mild pain initially and if gets impacted at gall bladder neck may cause moderate to severe pain over upper half of abdomen. Pain due to gall bladder stone may radiate to right upper back side.
Risk Factors- Once diagnosed with Gall bladder stone, type of patients who are at higher risk than others patients with Diabetes, Obesity, Immunocompromised, Elderly or if neglected case of gall stone disease leads to gangrene/ perforation of gall bladder. In all above cases, surgery is required once patient is diagnosed with problem.
Signs & Symptoms– Gallstones may be asymptomatic, even for years. These gallstones are called “silent stones”. The size and number of gallstones present does not appear to influence whether or not patients are symptomatic or asymptomatic. A characteristic symptom of gallstones is a “gallstone attack”, in which a person may experience intense pain in the upper-right side of the abdomen, often accompanied by nausea and vomiting, that steadily increases for approximately 30 minutes to several hours. A patient may also experience referred pain between the shoulder blades or below the right shoulder. These symptoms may resemble those of a “kidney stone attack”. Often, attacks occur after a particularly fatty meal and almost always happen at night, and after drink.
Clinicians confirms the diagnosis by way of a specific clinical examination called eliciting a positive Murphy’s sign which is pressing examining hand over right upper abdomen and asking patient to take deep breath. An inflamed gall bladder while inspiration on coming in vague contact of overlying clinicians hand causes pain.
Treatment- Once diagnosed the treatment of choice is Gall bladder removal. At PELVINIC, Laparoscopic gall bladder removal is practiced and is successful in almost all of the affected patients. Through laparoscopy, tiny holes are made (5mm) and gall bladder is removed and sent for pathological examination. With the advent of laparoscopy, not only surgical procedure has become more surgeon friendly but patient’s post operative recovery is excellent and patient can resume his/ her work the very next day. Dr Banerjee does standard 4 ports and single port Laparoscopic Cholecystectomy.