The gallbladder is a small, pear-shaped organ beneath the liver that stores and concentrates bile, a digestive fluid. Bile helps break down fats for nutrient absorption. When fatty meals enter the small intestine, the gallbladder contracts, releasing bile to aid digestion. While not essential for life, gallbladder problems sometimes require its removal.
Recognizing the Signs
Gallbladder issues often cause pain, typically in the upper right or central abdomen. This pain can intensify rapidly, radiating to the back or right shoulder blade. The discomfort may be sudden, sharp, or a constant, severe ache, sometimes worsening with deep breathing.
Other symptoms include nausea and vomiting, especially after fatty meals. Fever and chills may signal infection or inflammation. Jaundice, characterized by yellow skin or eyes, dark urine, or light stools, can indicate bile duct blockage. Persistent or severe symptoms warrant prompt medical attention.
Understanding the Diagnostic Process
Healthcare professionals use various diagnostic methods to confirm gallbladder conditions and their severity. Initial assessment includes a physical examination for tenderness or jaundice. Blood tests identify elevated white blood cell counts, suggesting infection or inflammation, and assess liver and pancreatic function to detect bile duct blockages.
Imaging tests provide detailed views of the gallbladder and bile ducts. An abdominal ultrasound is often the first choice for revealing gallstones, inflammation, or blockages. A hepatobiliary iminodiacetic acid (HIDA) scan tracks bile flow to assess gallbladder function and identify obstructions. For more detailed images, CT scans or MRI, including MRCP, may be used.
Conditions Requiring Removal
Cholecystectomy is recommended for conditions causing persistent symptoms or health risks. Symptomatic gallstones (cholelithiasis) are the most frequent indication. While many have asymptomatic gallstones, those causing recurrent pain (biliary colic) often require removal to prevent complications. These stones form when bile components like cholesterol harden.
Acute cholecystitis, gallbladder inflammation, typically occurs when a gallstone blocks the cystic duct, preventing bile drainage and causing irritation and infection. Chronic inflammation can scar the gallbladder, impairing its function. Removal is also indicated for gallstones migrating into the common bile duct (choledocholithiasis), leading to blockages and infections. Gallstone-induced pancreatitis also warrants removal to prevent recurrence. Rarely, large gallbladder polyps or cancer concerns may lead to cholecystectomy.
Potential Risks of Delaying Removal
Delaying medically indicated gallbladder removal can lead to serious complications. Untreated cholecystitis can worsen, causing tissue death (gangrenous cholecystitis). This may lead to gallbladder rupture, spilling infected bile into the abdomen and causing peritonitis, a medical emergency.
Recurrent gallstone attacks and persistent blockages can also lead to other complications. These include acute pancreatitis, a severe inflammation of the pancreas requiring hospitalization. Untreated bile duct blockages can result in jaundice and cholangitis, a life-threatening infection.