Gallstones (Cholelithiasis)

The gallbladder stores the bile produced by the liver. It is not a vital organ: removing it has no consequences, as digestion continues normally. Rarely, digestive problems such as diarrhea may occur, but they are temporary.

There are 2 main types of stones: cholesterol stones and pigment stones. Cholesterol stones form when there is excess cholesterol or a lack of bile salts. Black pigment stones form when unconjugated bilirubin increases, especially in cirrhosis or chronic hemolysis.

Gallstones may cause no symptoms or cause pain known as biliary colic: pain in the upper right abdomen or the upper middle abdomen (epigastrium), spreading to the right shoulder or shoulder blade, often triggered by a heavy meal.

Abdominal ultrasound is the best examination for diagnosing gallstones, better than CT scan and MRI.

The main complications are:

• Acute cholecystitis: inflammation of the gallbladder
• Stones passing into the common bile duct, leading to two potentially serious complications: cholangitis (infection of the common bile duct) and acute pancreatitis (inflammation of the pancreas)

Treatment of symptomatic gallstones is the removal of the gallbladder by laparoscopy (keyhole surgery).