It is important that the surgery of gallstones, which does not cause any symptoms in 75 percent of the cases, is performed during the period when the complaints are seen. Stating that laparoscopic surgery is the gold standard method in the treatment of gallstones and provides advantages to the patient, Prof. Dr. Mete Dolapçı gave information about gallbladder stones and polyps.
Bile digests fatsr
The gallbladder, which is responsible for storing and concentrating some of the bile secreted from the liver, is located just below the liver. The gallbladder contracts after meals, especially when fatty foods pass from the stomach to the duodenum, allowing the bile necessary for the digestion of fats to pass into the intestine.
Gallstones are more common in white-skinned and blond women.
The most common diseases of the gallbladder are gallstones and polyps. Less frequently, cancer can be seen in the gallbladder. While the incidence of gallstones in the community is around 10-20%; These stones are more common in white-skinned, blonde women and women who have given birth.
Watch out for the increase in cholesterol!
Cholesterol stones are the most common type of gallstones. An increase in the amount of cholesterol in the bile leads to stone formation. Another factor is stones caused by microbes reaching the gallbladder.
Not all indigestion and gas complaints indicate gallbladder disease.
About 75 percent of gallstones do not show any signs or symptoms. It is not a very correct approach to attribute some mild complaints such as indigestion and gas complaints to the gallbladder. However, usually complaints related to gallstones;
– Abdominal pain once a month or more
– 30 minutes – 24 hours of pain
– Pain that has occurred within the past year
– It is considered as pain that wakes you up at night.
Beware of the risk of complications
The presence of these complaints indicates that gallstones have become symptomatic. In 20 percent of symptomatic gallstones, there is a risk of developing complications of gallbladder inflammation (Acute cholecystitis), obstruction of the main bile ducts due to stones (Occlusion jaundice-cholangitis) and pancreatic inflammation (Biliary pancreatitis). These complications develop as a result of the stone in the gallbladder blocking the gallbladder duct and the main bile duct. In the event that the gallstones become symptomatic or one of these complications develops, the necessity of surgery definitely arises.
Stones and polyps can be visualized with modern technologies
With ultrasonography, which is the most reliable method used in the diagnosis of gallbladder diseases, stones and polyps can be displayed in detail. In cases where gallbladder cancer is suspected, computed tomography (MR) and further examinations may also be requested by the specialist doctor.
Laparoscopic surgery provides significant comfort to the patient
Gallbladder surgery is usually performed with a closed (laparoscopic) method and during the operation, the gallbladder is removed together with the stones in it. Laparoscopic surgery is the gold standard method for gallstones or polyps. However, sometimes the patient has had more than one abdominal surgery before, these surgeries are performed in the upper abdomen and adhesions occur in those areas, which may require the conversion of laparoscopic surgery to open surgery for the safety of the patient.
Although rare, open surgery can be performed in cases where anatomical structures cannot be adequately revealed during closed surgery. It should be known that switching to open surgery is not a complication, but a necessity in terms of patient safety.
Gallstones that do not cause complaints should not be removed for fear of cancer risk.
There is no confirmed scientific data that gallstones cause cancer. Although such a belief arises due to the presence of stones in the gallbladder of those with gallbladder cancer; It is not clear whether the stone causes cancer or whether the stone develops due to cancer. It is not correct for a person who has no complaints and has stones in the gallbladder to decide for surgery due to the risk of cancer.
Those with stones in the gallbladder should be fed carefully
The patient who has stones in the gallbladder and symptoms that require surgery should pay attention to his nutrition until the surgery. The contraction of the gallbladder is mostly caused by fatty foods, eggs and chocolate. Therefore, such foods should be avoided. After the surgery, there is no restriction in terms of nutrition for the patients.
Polyps are usually discovered incidentally.
Gallbladder polyps, which are the second most common among gallbladder diseases, are seen in approximately 5 percent of the society. Polyps that do not show signs or symptoms are usually detected incidentally in ultrasonographic examination. The majority of gallbladder polyps consist of cholesterol polyps attached to the gallbladder wall.
Size determines whether polyps are benign or malignant
The majority of true polyps are benign. The most important measure that determines whether gallbladder polyps are benign or malignant is the size of the polyps. While cancer is almost never seen in those with polyp diameters less than 5 mm; In those with a diameter greater than 1 cm, the cancer rate approaches 50 percent.
Small, multiple, and asymptomatic gallbladder polyps do not require immediate surgery. These polyps should be followed up for size with a six-month ultrasound control. However, if patients older than 50 years of age have gallstones with a single polyp and this causes complaints, an operation should be planned.