- As for kinda the anatomy of it,
the gallbladder's a four inch muscular sack,
that sits under the liver here in the right upper quadrant.
It does have a function, and the gallbladder's function
is to be a reserve, or a reservoir storage tank for bile
that our liver produces.
Bile is made, and comes down
and gets stored in the gallbladder.
When we eat our food comes into the stomach, this muscle
contracts and prevents the food from going through,
the food mixes with the stomach acids.
At that time, a hormone gets released
and then, goes up and stimulates the gallbladder
to contract and empty the bile into the main bile duct,
and then into the intestines.
After that happens and the food is also released,
the pancreatic enzymes are also released,
and this is where the digestion process begins.
The most common problem we can have with the gallbladder
is the formation of gallstones.
85% of all gallstones are cholesterol stones.
And they usually start off
being produced here in the gallbladder.
The problems that you can have
with gallstone related disease
is that when the gallbladder contracts,
the gallstone then migrate to what we call
the neck of the gallbladder, and form a partial obstruction.
When you have symptoms from gallstones,
the common symptoms are epigastric,
pain in the middle of the abdomen,
or pain the right upper quadrant,
some people feel it radiating to the back.
When its severe it's also associated with nausea,
if it gets very severe it can be associated
with vomiting as well.
Other findings that you can have
with gallstone related problems would be severe pain
that does not go away within four to six hours,
with associated fevers,
and some people may even get jaundice.
If you have those symptoms, those are people
who usually need to present to the emergency department
to be evaluated and treated sooner.
Other issues that you can have with the gallbladder
would be non-gallstone related problems,
or what we call biliary dyskinesia.
Just because you don't have gallstones
you can still have similar symptoms
with right upper quadrant pain and associated nausea.
But it means that the gallbladder
isn't functioning properly.
The workup for gallbladder related issues
would be laboratory studies to look at the liver function,
to look at your white count,
radiographic studies, meaning ultrasound.
Ultrasound is the best diagnostic tool
to evaluate the gallbladder,
for gallbladder wall thickness, or gallstones.
If that study is negative,
and you still have gallbladder type pain,
the next study would be a HIDA scan to look
to see if the gallbladder is not functioning properly.
If you have gallstone related pain
or non-functioning gallbladder,
the treatment is what we call
a laparoscopic cholecystectomy,
or removal of the gallbladder, through four small incisions,
and with little camera, and little instrument.
It is considered out-patient surgery,
you come in, get your surgery done,
and will go home the same day.
The recovery time is much faster
because it's minimally invasive surgery.
Most people can go back to normal activities,
without restrictions, in three weeks.
As far as dietary changes,
most people don't have to make any dietary changes,
80% of people can go back to eating anything they want.
There is that 20% that might find there's certain things
that still upset their systems,
and they may have to avoid those things, particularly fats.
With the gallbladder gone, you'll still be able
to make all the bile you need.
Instead of it being stored in the gallbladder,
it will then travel down the main bile duct
from the liver into the intestine,
so that you'll still have the bile you need for digestion.
Right now this is one of the common procedures
we do in the United States.
Just because you have gallstones
doesn't necessarily mean you need your gallbladder removed.
It's only if you're having gallbladder,
or gallstone related issues with right upper quadrant pain,
with radiation to the side, radiation to the back,
nausea, vomiting, or bloating.
Those are the most common symptoms
related to gallstone pain.
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