Gallbladder Disorders - Specialists and Information

The gallbladder stores the bile produced by the liver.

It consists of:

• Water
• Bile salts
• Cholesterol and
• phospholipids

Image of the gallbladder @ bilderzwerg /AdobeStock

The gallbladder can produce up to 1 liter of bile per day. Bile thickens in the gallbladder during periods of fasting. When food is ingested, the gallbladder releases bile into the duodenum via the bile duct. There, it breaks down dietary fats to aid digestion.

Other functions of the gallbladder include:

• Regulating cholesterol metabolism
• Activating the pancreas
• Transporting vitamins and various other substances

One of these is bilirubin, which is produced during the breakdown of red blood cells. This is responsible for the yellow-greenish color of bile.

The most common gallbladder and bile duct disorders are:

• Gallstones (cholecystolithiasis)
• Acute and chronic gallbladder inflammation (cholecystitis)
• Bile duct stones (choledocholithiasis)
• Inflammation of the bile ducts (cholangitis)
• Gallbladder polyps

Malignant tumors of the gallbladder, known as gallbladder carcinomas, are significantly less common.

The typical symptoms of gallstones are colic-like pains in the right upper abdomen that occur after eating fatty foods.

These pains may radiate in a belt-like pattern to the back and right shoulder and may be accompanied by nausea. They occur because the cystic duct is blocked or obstructed by a stone or inflammation.

If the stone moves from the cystic duct into the common bile duct, bile may back up into the liver. This leads to jaundice. Bile can also back up into the pancreas, potentially causing life-threatening complications.

Inflammation of the gallbladder is characterized by:

• Fever
• Severe pain and
• A significant sense of illness

Gallbladder stones discovered incidentally during an ultrasound examination (sonography) that do not cause any symptoms generally do not require treatment.

However, if gallbladder disease causes symptoms (colic, upper abdominal pain, a feeling of pressure), the filled gallbladder must be removed.

This is the only way doctors can prevent recurring symptoms, chronic irritation, and severe inflammation of the gallbladder.

Inflammation can occur in the gallbladder (cholecystitis), the common bile duct (cholangitis), or the pancreas (pancreatitis).

In most cases (95 percent), the gallbladder is removed laparoscopically (using the so-called “keyhole technique”). This procedure requires four small incisions.

The surgeon inserts the surgical instruments through these small incisions. Exceptions to this procedure include previous surgeries in the upper abdomen or severe pre-existing conditions.

In these cases, the procedure is performed through an abdominal incision, known as the “open or conventional” procedure. It is also possible to switch to the open procedure during a laparoscopic operation. This occurs in cases of severe inflammation or specific anatomical abnormalities.

If a stone is located in the common bile duct, endoscopic removal of the stone is necessary before the surgery.

In many cases, laparoscopic gallbladder removal can now be performed through a single access point (“single-port”). Doctors create this access point in the navel. Once the wound has healed, it is no longer visible. For this reason, the procedure is also called “scarless surgery.”

The advantages of this procedure are:

• Cosmetic benefit
• Fewer wound infections
• Less pain
• Low risk of an incisional hernia

At least 10 days before surgery for gallbladder disease, you must not take any anticoagulant medications such as aspirin, AS 100, or Plavix. 

You should also stop taking diabetes medications from the biguanide class (e.g., Glucophage, Metformin, Mescorit) 48 hours before surgery.

If you are receiving pre-hospital care, you should arrive at the hospital on an empty stomach on the day of surgery.

The surgery has no effect on:

• Bile production
• Transport to the intestines or 
• Digestion of food

For this reason, no special diet is required after surgery.

The hospital stay is usually 4 to 7 days. After laparoscopic surgery, you should take it easy for 1 to 2 weeks. 

After open surgery, doctors recommend avoiding strenuous physical activity for 2 to 3 months to prevent an umbilical hernia.