Gallstones

Gallstones

Gallstones are a very common problem, and often cause inconvenient and unpleasant indigestion symptoms and minor pain or nausea, as well difficulty with some foods – typically fatty meals including dairy products, cheese, fried and spicy foods, meaning patients have to avoid these. 

Surgery for Gallstones

Gallstones can now be treated very safely with modern “keyhole” abdominal surgery (laparoscopic surgery), usually performed as a day case procedure. The gallbladder and gallstones within it are removed, by carefully detaching the gallbladder from the attached structures (bile duct & liver). The surgical instruments used are inserted through small incisions, which heal well with minimal scarring, and cause little pain. 

Consultations will assess your abdominal symptoms and likely causes, offer diagnostic tests if required (e.g. scans), and discuss surgical treatment and recovery periods, as well as risks of surgery. Mark Tomlinson regularly performs both planned and emergency gallstone surgery, with very low risk to patients, rarely converting to open surgery, and excellent outcomes.

Whilst there are always potential risks associated with surgery, most of these are general risks applicable to all operations (bleeding, infection, clots /thrombosis, anaesthetic complications), and of injury or damage to structures close to the surgical target. For gallbladder surgery this means potential injury to the bile duct, or adjacent major blood vessels, stomach or bowel. Occasionally conversion from “keyhole” to more open surgery may be required to deal with more difficult or complex problems.

Why do we get gallstones, and what serious problems can they cause?

Gallstones form within the gallbladder, which is a small sac which stores the bile produced by the liver, so that when fatty meals are eaten there is some extra bile available to help digest the fat. Gallstones form as the environment of the bile within the gallbladder is abnormal. Gallstones can also quite frequently cause more serious medical infections and complications including:

• Severe pain and vomiting
• Jaundice – yellow eyes & skin due to a gallstone blocking the main internal tube which drains the liver (“the bile duct”)
• Gallbladder infection (“cholecystitis”)
• Bile infection (“cholangitis”)
• Inflammation of the pancreas gland ("pancreatitis")
• Severe infection in the blood ("septicaemia") and life-threatening organ failure (affecting the liver, kidneys, gut and occasionally heart and lungs)

Most patients develop many small gallstones, though these often stick together making a composite or multi-layered single larger gallstone. Small gallstones are more dangerous, as they can fall out of the gallbladder and pass into the main tube (the bile duct) which drains the liver of bile, and they block the duct. This causes jaundice, severe pain, and can lead to bile infection (cholangitis) or inflammation of the pancreas gland – both of which can lead to life-threatening septicaemia and multiple organ failure. Solitary larger gallstones tend to cause either pain from the gallbladder (biliary colic), or infection within the gallbladder.