Gallstones are solid stones formed in the gall bladder from cholesterol.............


Gallstones are solid stones formed in the gall bladder from cholesterol, bile salts and calcium. They can vary in size from a few millimeters to a few centimeters.

What causes gallstones?

Gallstones are formed when bile contains too much cholesterol. The excess cholesterol forms crystals from which gallstones are made.

Who is at risk of developing gallstones?

Gallstones are seen in all age groups but they are rare in the young. The possibility of developing gallstones increases with age.

The following groups are considered to be at increased risk:

obese people, people with a high blood cholesterol level, women who take drugs containing estrogen, eg contraceptive pills., people with diseases such as chronic intestinal inflammation (Cohn’s disease and ulcerative colitis) and hemolytic disorders. .

What are the symptoms of gallstones?

It is thought that approximately two thirds of patients will have no trouble at all from their gallstones and only one third of patients will at some time experience symptoms. These symptoms can be extremely variable but usually present in two ways. Acute cholecystitis or chronic cholecystitis. Both the conditions may lead to complications if not treated properly.

Presence of gallstones in other parts of the biliary tract can cause obstruction of the bile ducts causing obstructive jaundice, cholangitis and pancreatitis. Either of these conditions can be life-threatening and are therefore considered to be medical emergencies.

Types of gall stones: Three types

Cholesterol stones: Cholesterol stones vary from light yellow to dark green or brown and are oval, between 2 and 3 cm long, each often having a tiny, dark, central spot. To be classified as such, they must be at least 80% cholesterol by weight

Pigment stones: Pigment stones are small and dark and comprise bilirubin and calcium salts that are found in bile. They contain less than 20% of cholesterol

Mixed stones: Mixed gallstones typically contain 20–80% cholesterol (or 30–70%, Other common constituents are calcium carbonate, palmitate phosphate, bilirubin, and other bile pigments. Because of their calcium content, they are often radiographically visible.

Treatment :

Cholecystectomy , which is removal of gallbladder. It is indicated in symptomatic patients. The lack of gallbladder may have no negative consequences in many people.

There are two surgical options for cholecystectomy: Laparoscopic cholecystectomy ( keyhole surgery) is performed via four small puncture holes for a camera and instruments. Post-operative care typically includes a same-day release or a one night hospital stay, followed by a few days of home rest and pain medication. Nowadays more than 90 per cent cholecystectomy performed by laparoscopic surgery

Open cholecystectomy (open surgical method) is performed via an abdominal incision (laparotomy) below the lower right ribs. Recovery typically requires 3–5 days of hospitalization, with a return to normal diet.

Prof. Mohammad Ali