The most common problem which is encountered is the formation of gallstones. The classical risk factors include being female, obesity, over 40 years of age – in reality, anyone can get gallstones.

Biliary colic – when the gallbladder contracts, the stones move around and cause pain. This usually occurs after eating, and subsides after 1-2 hours. The frequency of attacks may be reduced by eliminating fat or oil from the diet.

Cholecystitis – if a stone gets impacted of stuck at the entrance of the gallbladder, it can lead to inflammation and infection of the gallbladder. This will cause more prolonged pain which doesn’t subside, and you may also experience a fever. This condition needs to be treated with antibiotics, and ideally prompt removal of the gallbladder.

Jaundice – stones may slip out of the gallbladder and enter the tube called the ‘bile duct’ which drains the bile from the liver into the intestine. If this happens, it may obstruct the liver and lead to jaundice – a yellow discoloration of the skin. You may also notice that your urine appears darker, and your faeces appears pale. A blocked bile duct can also lead to infection of the bile, a serious condition called cholangitis – you will need to have a procedure to remove the stone or put a stent to bypass the blockage.

Pancreatitis – if a stone escapes the gallbladder and falls into the bile duct, it can also block the duct of the pancreas, an organ which makes a lot of digestive juices. This can lead to the pancreas ‘attacking itself’, a condition called pancreatitis. This ranges from mild to severe and life-theatening. If you have an attack of pancreatitis and have proven gallstones, it would be recommended to remove your gallbladder, to reduce the risk of another potentially more serious attack.

Gallstones are most commonly detected on an ultrasound of your gallbladder. This may be done because you had a symptom as described above, or your blood tests may show an abnormal pattern. Sometimes they may be detected incidentally while investigating another unrelated condition.

Other tests which you may undergo include CT scans, MRI scans, or a nuclear medicine test called a HIDA scan, which measures the activity of the gallbladder itself.

There are certain things which you can do to reduce the frequency of attacks, the main one being to eliminate fat from your diet. Ultimately, the only way to deal with gallstones with certainty is to remove the gallbladder which removes the source of the problem.

The operation is called a cholecystectomy, and is one of the most common surgical procedures performed. The standard way it is done is via a ‘key-hole’ or laparoscopic approach. This involves a small cut at the belly button and three more small cuts around the abdomen. Through these cuts we can place a camera and instruments to safely remove the gallbladder. The recovery is generally very quick, and you may be able to go home on the same day, or the next.

Open surgery, with a larger cut, may be necessary in a small number of cases if it is not safe to proceed laparoscopically. This may happen for example if there is too much scar tissue from previous operations. The stay in hospital may be slightly longer and recovery will also be slower.

During the operation we also perform an x-ray by injecting some contrast into the bile duct. This allows us to confirm the anatomy of the biliary tree, and to make sure that there are no stones which have escaped into the main bile duct.

A drain tube may sometimes be left to drain excess fluid. It usually only stays in for 24hrs.

Bleeding and infection are common to most operations.

Leakage of bile from where the gallbladder has been removed – this may require another procedure to put a stent inside the bile duct.

Injury to other organs such as the intestine may occur if there is a lot of scar tissue.
Injury to the bile duct is a rare but serious problem – it requires a big operation to reconnect the bile duct.