Gall Bladder Stones/ Laparoscopic Cholecystectomy in Mumbai, India

Gall stone disease is one of the most common problems that affect the digestive tract. It is seen in 11% to 36% of people. Gall stones are solidified pieces of digestive fluid that form and collect in the gall bladder. The gall bladder is a pear-shaped organ below the liver that serves to store bile. Bile is a digestive juice which is produced by the liver and stored in the gall bladder. In response to food intake, bile is released into the small intestine via a connecting tube called the bile duct. Gall stones can be single or multiple. There size can also be variable. They can be as small as a grain or as large as a medium sized golf ball.

Gall stone formation

Gall stones form as a result of solids settling out of a solution. Depending on their cholesterol content, gall stones are classified as cholesterol stones or pigment stones. Cholesterol stones are more common as compared to pigment stones.

Who is at risk for gall stone disease:

Certain conditions predispose to the development of gall stone formation. Some of these are listed as under:

• Female gender
• Obesity
• Pregnancy
• Dietary factors
• Inflammatory bowel disease
• Surgery of the stomach
• Surgery of the small intestine
• Sickle cell disease
• Thalassemia
• Hereditary spherocytosis
• First degree relatives of patients with gall stones

Signs and symptoms of gall bladder stones

Many patients with gall stones may not have any symptoms throughout life. However, it is not possible to predict which patients will progress to have symptoms. Rarely, complications of gall stones can be a presenting feature in some patients.

• Pain is the chief symptom associated with gall stone disease. Pain is episodic. Typically, patients feel well in between the episodes of pain. Pain usually occurs after a fatty meal and is felt in the right upper abdomen or in the central part of upper abdomen. It may radiate to the back. It lasts for 1 to 5 hours. Such episodes happen due to a stone getting stuck in the cystic duct and are called as – Biliary Colic.
• Bloating, gaseousness, acidity and belching are a few other symptoms that may be experienced.
• If the pain becomes continuous and lasts for more than 24 hours, it is suggestive of inflammation of the gall bladder called as- Acute Cholecystitis.
• At times the stones may slip out of the gall bladder into the common bile duct. These can lead to obstruction or inflammation of the common bile duct leading to obstructive jaundice or cholangitis, respectively.
• A stone may also slip into the pancreatic duct and can lead to acute pancreatitis.
• Rarely gall stones may lead to rupture of the gall bladder into the bile duct or the small intestine leading to a fistula formation.

Watch Dr. Aparna Govil Bhasker talk about symptoms of gall bladder stones-

Investigations

• Ultrasonography of the abdomen is the diagnostic test for gall stone disease.
• Routine blood work including liver function test and serum amylase and lipase must also be included.
• MRCP or CT scan of the abdomen may be needed on case-to-case basis.

Treatment of gall stone disease

A cholecystectomy or removal of the gall bladder is the treatment for gall stone disease in symptomatic patients. Surgery is performed laparoscopically in most cases. It can also be done through a single incision in the navel. The advantage of laparoscopy is that it causes very less trauma to the patient. It is less painful and leads to early recovery and an early discharge from the hospital. Most patients go home the next day after their surgery.

In case of acute cholecystitis, it is advisable to do an early surgery (cholecystectomy) within 2 to 3 days of onset of symptoms. When patients present late, a trial of antibiotics and conservative treatment may be given, however, intervention in the form of surgery may be needed if the symptoms are not settling down.

Per-cutaneous drainage may be needed in patients who are medically unfit for surgery.

An ERCP (Endoscopic retrograde cholangio-pancreatography) with or without stent placement may be required if the stones have slipped into the common bile duct or the pancreatic duct.

Cost of gall bladder surgery in Mumbai

Cost of gall bladder surgery varies from hospital to hospital. We are associated with multiple hospitals and believe that quality treatment must be accessible to all. Post your consultation we will guide you about the best possible option for your surgery.

Insurance coverage for gall bladder surgery in Mumbai

Gall bladder surgery is covered by health insurance.

Frequently asked questions

• Can gall stones be removed without surgery?

No, gall stones cannot be removed without surgery. Please do not get influenced by quacks who claim to melt the stones without surgery. Many a times we see that fear of having surgery pushes people into such unproven therapies and they land up with life-threatening complications.

• Can gall stones be removed without removing the gall bladder?

No, gall stones cannot be removed without removing the gall bladder. World over the standard treatment for gall stone disease is “cholecystectomy”. Please do not believe anyone who tells you otherwise.

• Can galls stones pass out on their own?

Yes, smaller gall stones can slip out into the bile duct during contraction of the gall bladder. If these stones are very small, they will pass down into the small intestine without creating any problems. However, if the stones are bigger, they can tend to get stuck in the cystic duct or the common bile duct and lead to pain. In some cases, they may slip into the duct of the pancreas and lead to pancreatitis as well. Even if the stones pass out, new stones will continue to form in the gall bladder.

• Is gall bladder surgery painful?

Gall bladder surgery is performed by minimal access/ laparoscopy. Laparoscopic surgery is much less painful as compared to open surgery. Patients can be mobilized out of bed within a few hours of surgery and it does not entail any kind of bed rest.

• What are the dietary restrictions after gall bladder surgery?

It is advisable to avoid oily, fatty and spicy diet for a few weeks after gall bladder surgery. Once the gall bladder is out, the body needs some time to adjust. Usually, these dietary restrictions are there for about 6 to 8 weeks.

• What are the side effects of gall bladder removal? Can I lead a normal life without the gall bladder?

A small number of patients experience certain digestive issues after gall bladder removal. Some degree of bloating, indigestion or at times lose motions can be present. These symptoms are usually self-limiting and settle down in a few days.

• How long can live with gall stones?

If the gall stones are totally asymptomatic and not causing any problems, you may wait. However, if you have multiple tiny stones or are diabetic, it is advisable to be watchful of symptoms and seek medical help at the earliest.

• When should one visit a doctor?

If you are experiencing any of the signs and symptoms listed above you must seek medical help at the earliest.

• Are there any risks involved in gall bladder surgery?

Laparoscopic cholecystectomy is a safe surgery. Like all surgeries there is a small risk of complications in this surgery too. Bile duct injury is one of the main complications of gall bladder surgery.

To watch Dr. Aparna G Bhasker giving out some tips to patient who have undergone gall bladder surgery

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