The gallbladder is pear-shaped, attached to the lower surface of the liver, and is connected to the main bile ducts by a duct we call the cystic duct. The main task of the gallbladder; It is to store and concentrate some of the bile produced by the liver, especially during fasting periods, and to be secreted back into the intestine during digestion. The gallbladder has a volume of about 50 ml. It can concentrate bile up to 10 times. Following the arrival of food in the stomach, it contracts and empties more than half of its contents into the intestine within half an hour. The liver can also send some of the bile it produces directly to the intestine without the need for the gallbladder. In the absence of a gallbladder, all of the bile can be delivered to the intestine through the common bile duct. Therefore, the gallbladder is not an indispensable organ for life. It does not create a vital defect in functioning when it needs to be removed in case of inflammation.
Why do gallstones occur?
Some of the bile produced by the liver is stored in the gallbladder, especially during hunger. The main components of bile are cholesterol, lecithin, bilirubin and calcium. Under normal conditions, there is a balance between these substances that make up the bile. In case of disruption of this balance, gallstones and sludge are formed. The solubility in the medium decreases and the liquid content becomes extremely dense. Some substances that need to be discarded crystallize and precipitate and form sediment. Precipitated cholesterol crystals or calcium particles combine with the gelatinous substance secreted from the gallbladder wall to form biliary sludge. Long periods of fasting increase the formation of bile sludge. The deterioration of the contraction and relaxation function of the gallbladder and the secretion function from the inner wall of the wall prepare the ground for the stone. Over time, a harder core forms and becomes gallstone. There may be a familial predisposition for gallstones.
Gallstones are more common in overweight, forties, women, and those who have given birth multiple times. In order for gallstones to cause discomfort to the person and cause complaints, they must become clogged at the mouth of the canal or reach a size that will cause damage to the inner wall.
There were also factors that accelerated the formation of gallstones, some of them: patients who underwent gastric surgery, patients who underwent bypass surgery due to obesity, morbid obesity, after injury to the vagus nerve, after large bowel resections…
Gallbladder inflammation (cholecystitis)
Gallbladder inflammation can occur in two forms, acute and chronic. In both, gallbladder inflammation usually develops as a result of obstruction of the gallbladder duct. The stone or sludge formed in the gallbladder sits in the mouth of the gallbladder duct and does not allow the bile in the gallbladder to discharge. The gallbladder swells, stretches. Edema develops in the wall of the sac and its blood supply begins to deteriorate. It is possible for the deterioration to progress gradually to decay and perforation.
The most important symptom of gallbladder inflammation is pain in the abdomen, especially in the upper right side. It usually happens after meals. It is typical for the pain to hit the back and shoulder. Pain may often be accompanied by complaints such as nausea, bloating, indigestion, and sometimes burning, heartburn.
Who needs gallbladder surgery?
In gallbladder problems, patients generally have dyspeptic complaints such as bloating, indigestion, intolerance to fatty foods, nausea after meals, and abdominal pain in the upper right side. In these patients, if stones, sludge or inflammation are detected in the gallbladder on ultrasonography, closed gallbladder surgery should be performed.
Gallbladder surgery is performed on patients with stony gallbladder who have had an attack of acute or chronic cholecystitis (inflammation of the gallbladder).
Surgery is performed in patients with multiple small gallstones who have had acute pancreatitis (inflammation of the pancreas), swelling of the gallbladder without stones or sludge in the gallbladder, and patients with biliary inflammation (acalculous cholecystitis).