GALLBLADDER SURGERY

What Are Gallstones?

Gallstones are solid particles that form in the gallbladder, a small organ located beneath your liver. They are common, with an estimated 30% of Australians over the age of 50 having gallstones.

The gallbladder stores bile, a digestive fluid produced by the liver, which helps break down fats in the food you eat.

Gallstones can vary in size—from as small as a grain of sand to as large as a golf ball—and can develop when the substances in bile, such as cholesterol or bile salts, become imbalanced in their concentrations, ultimately solidifying into a stone.

There are two main types of gallstones:

  1. Cholesterol Gallstones – The most common type, made primarily of hardened/crystalised cholesterol

  2. Pigment Gallstones – These are smaller and darker, formed from excess bilirubin, a substance produced when the body breaks down red blood cells

Gallbladder Surgery Details

Risk Factors for Gallstones

Certain factors can increase your risk of developing gallstones, including:

  • Age: Gallstones are more common in adults over 40, especially in women

  • Gender: Women are more likely to develop gallstones than men

  • Obesity: Being overweight or obese increases the likelihood of gallstone formation

  • Rapid weight loss (i.e. after bariatric/weight loss surgery)

  • Diet: A high-fat, high-cholesterol, or low-fibre diet can contribute to the development of gallstones

  • Family history of gallstones

  • Medications, including the oral contraceptives and hormone replacement therapy

  • Diabetes: People with diabetes, especially those with poorly controlled blood sugar, may be more prone to developing gallstones.

  • Certain Health Conditions: Liver disease, Crohn's disease, or cirrhosis can increase your risk.

  • Pregnancy: Hormonal changes during pregnancy can increase the risk of gallstones.

Symptoms of Gallstones

Not all individuals with gallstones will exhibit symptoms. However, if symptoms do arise, it is generally advised to undergo a cholecystectomy (gallbladder removal) to prevent further episodes of pain and avoid potential complications associated with gallstone disease.

Common symptoms include:

  • Pain (usually in the upper right abdomen): This pain can be sudden and severe, and it often comes in waves. It may last from a few minutes to several hours.

  • Nausea and vomiting: Often accompanying the pain.

  • Indigestion or bloating: Feeling full or uncomfortable after eating.

  • Jaundice: Yellowing of the skin or eyes, which may occur if a gallstone blocks the common bile duct

  • Dark Urine or Pale Stools: This can also be a sign that a bile duct is blocked

Complications of Gallstones

If gallstones cause a blockage or become infected, they can lead to serious complications, including:

  • Cholecystitis: Inflammation & infection of the gallbladder, usually caused by a gallstone blocking the cystic duct

  • Pancreatitis

  • Choledocholithiasis: Gallstones that have passed out of the gallbladder and into the common bile duct. This can lead to pain and jaundice

  • Bile Duct Infection (Cholangitis): Infection of the bile ducts, which can cause fever, pain, and jaundice.

  • Gallbladder Cancer: While rare, long-term gallstone disease can increase the risk of gallbladder cancer

Diagnosis of Gallstones

The common investigations used to diagnose gallstones include:

  • Ultrasound: This is the most common and effective imaging test for detecting gallstones

  • CT or MRI (MR Cholangio-Pancreatography, MRCP): In some cases, these imaging tests may be used to get a more detailed view of the gallbladder

  • Blood Tests: These can help detect signs of infection, inflammation, or complications related to gallstones, such as liver or pancreatic issues

Treatment Options for Gallstone Disease

  1. Observation (If Asymptomatic): If gallstones are not causing symptoms, it may be recommended simply monitoring them for symptoms

  2. Surgical Treatment – Cholecystectomy

The most common treatment for symptomatic gallstones is the removal of the gallbladder, a procedure called a Cholecystectomy. This surgery is usually done laparoscopically (through small incisions, using small instruments and a camera).

Dr. Matthew Stokes & Dr Josh Hammerschlag have extensive experience in performing minimally invasive gallbladder removal, both in the elective and emergency settings.

Furthermore, both Dr. Stokes & Dr. Hammerschlag have specialist training in performing intra-operative removal of gallstones that have become lodged in the common bile duct (CBD), a condition called choledocholithiasis.

Recovery After Gallbladder Removal

The recovery after a minimally invasive removal of gallbladder (Laparoscopic Cholecystectomy) is far quicker than the traditional “open” approach.

After a laparoscopic cholecystectomy, most patients will stay in hospital for only 1-2 nights. Typically, within 1–2 weeks after surgery, you will have fully recovered and are able to return to work and normal daily activities.

You may experience some digestive changes, like more frequent bowel movements or difficulty digesting fatty foods, but this often improves within the first 3 months after surgery. 

The surgeons at South East Upper GI Surgical Group are available for urgent referrals of emergency presentations of symptomatic gallstones (biliary colic and acute cholecystitis). Please contact the rooms on 03 9750 0700 to make an urgent referral. 

Personalised, Compassionate Surgical Care

South East Upper GI Surgical Group warmly welcomes both private and public patients for new consultations and can see urgent referrals quickly, including new cancer diagnoses.