A hollow organ situated between the liver and the digestive tract – that is the gallbladder. But what exactly is its function? And can it really be removed with virtually no consequences, as we so often hear? Usually, this sac, which stores up to a liter of bile, only attracts attention when it causes problems – that is, when there is an inflammation of the gallbladder or when gallstones are causing trouble. In our part of the world, gallbladder surgery is among the most common operations. These procedures fall within the field of visceral surgery – that is, performed by surgeons who specialize in the abdominal cavity. The Leading Medicine Guide spoke to a renowned specialist on this topic, who, like few other specialists, has dedicated his career to gallbladder surgery: PD Dr Emanuel Sporn, who was appointed Associate Professor back in 2012, is thoroughly familiar with all abdominal surgeries and is also one of the leading experts in vascular surgery. He runs two renowned private practices in Vienna. There, he is “in the fortunate position of being able to devote myself exclusively to my private patients”, as he himself puts it. In a pleasant, trusting atmosphere, he takes plenty of time for personalized care – from the initial consultation to the follow-up check-up. Incidentally, he performs operations in Vienna’s most prestigious private clinics.
Leading Medicine Guide: What exactly is the gallbladder – and what is bile made of?
PD Dr Emanuel Sporn: Bile consists mainly of water, bile salts, cholesterol and phospholipids. It is a greenish-yellow viscous fluid that is primarily necessary for digestion, specifically for breaking down dietary fats. Bile breaks down fat globules into tiny droplets, which can then be broken down more easily in the digestive tract and better absorbed by the intestinal cells. Bile also regulates cholesterol metabolism and stimulates the pancreas. It is responsible, for example, for the transport of vitamins and other substances.
Gallbladder surgery forms a key part of your work as a visceral surgeon. How do gallstones form, given that they can be so painful for the person affected?
PD Dr Emanuel Sporn: Gallstones form when there is an imbalance in the composition of the bile. This leads to the crystallisation of the bile and the formation of so-called gallbladder sludge, a sand-like deposit which can then develop into gallstones. The development of gallstones is often observed to run in families and is largely beyond our control. However, there are also certain risk factors for the development of gallstones. These are more commonly found in middle-aged women, in overweight individuals and in people with weight fluctuations.
Leading Medicine Guide: What is so dangerous about gallstones?
PD Dr Emanuel Sporn: Gallstones can trigger colic – which refers to cramp-like pain in the abdomen. Furthermore, gallstones can cause cholecystitis, an inflammation of the gallbladder wall. A potentially life-threatening condition that can be triggered by gallstones is pancreatitis. In patients who experience such symptoms or problems due to their gallstones, surgical removal of the gallbladder and the stones it contains should be performed.
Leading Medicine Guide: The gallbladder is often removed quite quickly. What is the function of the gallbladder if it seems we can manage perfectly well without it?
Prof. Sporn: Usually, only the gallbladder is removed; it merely acts as a reservoir for the bile produced by the liver. After the gallbladder has been removed, the liver naturally continues to produce bile, which is required for the digestion of fats, and secretes it into the duodenum via the bile duct. Therefore, patients do not lose their gallbladder following surgical removal.
That’s interesting to know. Thank you very much for the informative discussion about the gallbladder, Professor Sporn!
You can find further information on gallbladder surgery here.
Associate Professor Dr Emanuel Sporn, a specialist in surgery, visceral surgery and vascular surgery, is a specialist in abdominal and breast surgery in Vienna, where he runs two private practices. His areas of expertise include hernia surgery, breast cancer surgery, gastrointestinal surgery (including gastroscopy and colonoscopy), oncological surgery and gallbladder surgery. PD Dr Sporn has also completed further training, for example in vascular surgery. This helps him, on the one hand, to assess conditions more effectively and, on the other hand, to perform major operations on cancer patients more safely and to manage critical situations during surgery more reliably.
Image source: (c) Kateryna_Kon, (c) PIC4U – Adobe Stock/PD Dr Sporn
