Gallbladder Disease

Definition

The gallbladder is a small organ that aids in fat digestion by concentrating bile produced in the liver. Gallbladder diseases is any dysfunction, damage or destruction of the gallbladder. It includes conditions such as :

  • Cholelithiasis (gallstones) – presence of one or more gallstones in the gallbladder.
  • Cholecystitis – inflammation of the gallbladder.
  • Gallbladder tumors – cholangiocarcinomas, gallbladder carcinomas and gallbladder polyps.

Symptoms

The symptoms of gallbladder diseases depend on the condition present.

Cholelithiasis (gallbladder stones):

  • Gallstones are frequently asymptomatic.
  • Blockage of bile ducts by gallstones causes biliary colic, which causes pain in the middle of the upper abdomen.

Cholecystitis (gallbladder inflammation):

  • Pain and tenderness of upper abdomen are the most common symptoms.
  • Fever, nausea, chills, and vomiting are sometimes seen.

Gallbladder tumors:

  • Most gallbladder tumors may remain asymptomatic.
  • Symptoms, when present, may include jaundice, pain above the stomach, nausea, fever, vomiting, bloating, and abdominal lumps.

Causes

Gallbladder stones

  • Gallbladder stones are of different types.
    – Cholesterol deposits form cholesterol gallstones.
    – Excessive pigment formed by bilirubin may cause pigment gallstones.
  • Some antibiotics like ceftriaxone and substances like calcium carbonate can also lead to gallstones.
  • Risk factors for gallstones include female sex, increased age, obesity, certain dietary ingredients, and a family history.

Gallbladder inflammation

  • A small duct called cystic duct joins gallbladder with bile duct. An obstruction of this cystic duct with a gallstone results in inflammation of gallbladder.
  • Chronic illness, infections, or weak immune system can also lead to inflammation.
  • Increasing age, female sex, obesity, use of birth control pills, multiple pregnancies, and heredity are known risk factors.

Gallbladder tumors

  • The exact causes of gallbladder tumors are not known.
  • Inflammation of bile ducts, parasitic infection of liver, and swelling of bile ducts can result in development of gallbladder tumors.

Treatment

Surgical removal of the gallbladder (cholecystectomy) is often performed. Cholecystectomy is well-tolerated in humans.

The treatment options depends on the type of gallbladder disease.

  • Gallstones
    – Cholecystectomy is the standard treatment for gallstones in the gallbladder.
    – Gallstones stuck in the hepatic or bile ducts are extracted surgically in a procedure known as sphincterotomy.
    – Some oral medications (like ursodiol) are recommended to dissolve cholesterol gallstones.
    – Extracorporeal shock-wave lithotripsy (ESWL) is used for extraction of gallstones lodged in bile ducts. This method employs shock waves to shatter the gallstone, which is either extracted surgically or excreted from the body.
  • Gallbladder inflammation
    – Cholecystectomy is usually performed in the case of gallbladder inflammation.
    – Adequate hydration and use of medications also helps in managing gallbladder inflammation.
    – Non-steroidal anti-inflammatory analgesics are often recommended to patients.
    – Antibiotics like ceftriaxone, metronidazole, piperacillin, tazobactam, ticarcillin, or clavulanate can be given to treat possible infections.
  • Gallbladder tumors
    – Many gallbladder tumors are treated symptomatically.
    – Stenting or bypass surgery is frequently performed. These procedures are able to provide relief in most cases.
    – Bile is drained mechanically in many patients. This procedure relieves patients from risks of severe infection and pain due to obstruction of bile ducts.
    – Liver transplant and cholecystectomy are reserved for very rare cases.

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