CHOLOLITHIASIS

The gall bladder (commonly gall) is a pear-shaped organ located below the right side of the liver. Its main function is to collect part of the digestive fluid (gall) produced by the liver.

This fluid is released from the gall bladder after eating, when needed, helping to digest mainly fatty substances. The gall is transported through narrow tubular canals, the cystic duct and the gall duct, into the duodenum and from there to the small intestine.

Gall bladder problems are usually caused by the presence of gall stones (stones). They are mainly formed by cholesterol and gall salts in the gall bladder or gall duct.

The causes of gall stones are not known, so there are no ways to prevent their formation.

If these stones block the flow of gall to the intestine, they cause the bladder to swell, resulting in:

• Acute abdominal pain
• Vomits
• Indigestion
• Fever (in some cases).

In addition, if gall stones block the common gall duct, it can cause jaundice (yellowing of the skin) or pancreatitis.

The presence of gall stones may be accompanied by symptoms, but is often asymptomatic. The safest, most painless and economical method of diagnosis is ultrasonogram.

Surgical removal of the gall bladder is the most appropriate and safest treatment for gall stones and does not cause any digestive disorders in most patients.

In the old days, gall bladder removal required a large incision, a hospital stay for several days and a lot of pain after surgery. With the advent of the revolutionary laparoscopy method, cholecystectomy data changed in the early 1990s. In this method, a laparoscope (small telescope connected to a special camera) is inserted through a tube 5-12 mm in diameter, thus allowing the surgeon to see the patient’s internal organs 10 to 15 times larger than they actually are.

At the same time, other tubes enter the abdomen allowing the surgeon to work internally. If at the discretion of the surgeon intra-operative cholangiography is needed, this can be done from the same incisions.

However, in a very small number of patients, less than 1% (in the case of a specialized surgical team), this method cannot be applied, due to special conditions. The decision for “open” surgery is at the discretion of the surgeon before or even during the operation.