HILTON HEAD GENERAL & LAPAROSCOPIC SURGERY, PA

SURGICAL SPECIALISTS

 

Richard L. Hussong, Jr, MD

Thomas P. Rzeczycki, MD

Robert L. Soares, Jr, MD

THE GALLBLADDER

The gallbladder is a small sac like organ adjacent to the liver.  It is located in the upper right abdomen under the ribs.  The gallbladder connects via the cystic duct to the common bile duct (CBD), which transports bile from the liver to the intestine.  Bile is a substance produced by the liver that helps to digest fat.  The gallbladder stores bile and contracts to release it into the intestine when a meal has been ingested.

 

GALLBLADDER DISEASE

Gallbladder disease is usually secondary to gallstones.  The incidence of gallstones in the US population is approximately 10 percent and increases with age.  Gallstones are also more prevalent in females.  Fortunately, many people with gallstones will never go on to develop gallbladder disease.

Gallbladder disease developing in the absence of stones is the result of abnormal emptying and is labeled biliary dyskinesia.

 

SYMPTOMS

Most individuals with gallbladder disease will have symptoms; however, they may sometimes be very subtle.  Classically, patients will have sharp crampy pain in the upper right abdomen.  The pain may also travel into the right back and shoulder.  Often the pain is associated with nausea and vomiting and may be relieved with belching or throwing up.  These episodes of pain may be precipitated by food, especially if it is greasy, spicy or fatty.

The pain is caused by a stone blocking  the cystic duct,  which is the duct that carries the bile from the gallbladder to the CBD.  Sometimes a stone may even travel into the CBD, and if it causes a blockage at this location jaundice, yellow discoloration of the skin and eyes,  will likely develop.

The CBD travels through the pancreas before emptying into the intestine, so if a stone is completely passed it may cause pancreatitis, inflammation of the pancreas.  The symptoms of pancreatitis are usually severe upper abdominal and/or midback pain with nausea and vomiting.

The development of fever, jaundice, or pancreatitis with a gallbladder attack is serious, and a physician should be notified promptly.

 

DIAGNOSIS

Since most gallbladder disease is caused by the gallstones, the initial diagnostic test obtained is usually a gallbladder ultrasound.  The ultrasound uses sound waves to painlessly visualize the gallbladder and detect the presence or absence of gallstones.

If gallstones are not found but gallbladder disease is strongly suspected then a HIDA scan will often be done.  This test follows and injected dye through the liver and into the bile ducts to see if the gallbladder fills and empties normally.  If it is not emptying normally and/or pain is reproduced then the patient has biliary dyskinesia.

 

 

 

Gallbladder Surgery