Gallstones are common in both men and women, with up to 30% of individuals remaining asymptomatic. Gallstones may be composed of cholesterol, pigment, or calcium. They form when there is an imbalance between bile salts and cholesterol, causing cholesterol to precipitate into crystals. These crystals can accumulate within the gallbladder, leading to the formation of gallstones or sludge.
Imbalances in estrogen and progesterone production can affect gallbladder motility, contributing to gallstone formation. Additionally, certain hematological conditions can promote the formation of black pigmented stones.
Diagnosing Gallstones
Ultrasound remains the gold standard for diagnosing gallstones.
Biliary Colic
Biliary colic is condition when gallstones intermittently lodge within the neck of the gallbladder, leading to an obstruction of bile flow. This can result in debilitating right upper abdominalor epigastric pain. When the gallbladder relaxes, the gallstone may fall back into the body of the gallbladder, causing the pain to subside.
Biliary colic typically resolves within 12hours. If the pain persists longer, it may suggest cholecystitis. Recurrent episodes of biliary colic are an indication for gallbladder removal. Fatty foods will trigger the release of a hormone called CCK that is responsible for gallbladder contractility. Adopting a low-fat diet and avoiding fatty foods can help reduce the frequency and severity of attacks.
Cholecystitis
Cholecystitis is a condition when the gallbladder becomes inflamed, often due to gallstones becoming trapped. This results in non-resolving pain and discomfort as bile flow becomes impaired. Chemical reactions within the gallbladder then trigger inflammation.
Patients commonly describe pain under the right rib cage or in the center of the chest, which can be alarming and, for some, mimic a heart attack. Vomiting is also a frequent symptom.
Untreated cholecystitis can lead to serious systemic infections that may be life-threatening. Early intervention with antibiotics and surgery is typically recommended. However, the decision will be made based on individual circumstances. Dr. Petrushnko is highly skilled in performing both elective and emergency keyhole gallbladder surgeries.
Laparoscopic Cholecystectomy
Laparoscopic cholecystectomy involves the removal of the gallbladder and requires a thorough understanding of gallbladder anatomy, including its variations. During the procedure, Dr. Petrushnko routinely performs a cholangiogram (X-ray) to assess the biliary anatomy and check for gallstones that may be lodged in the bile ducts (which occurs in up to 3% of cases).
In rare cases, an open surgical approach may be necessary.
