In Singapore, gallstones are the most common type of gallbladder disease. Stone formation in the gallbladder is a fairly common condition that typically affects middle-aged women who are a bit overweight. It can also affect men.
Dr Wong Nan-Yaw, an experienced colorectal surgeon, tells you what you need to know about gallstones.
What is the gallbladder?
The gallbladder is an organ located on the right side of the abdomen just under the liver. Its main function is to store digestive enzymes to aid in the digestion of fat.
It is not an essential organ and patients can live perfectly normal lives if the gallbladder was removed.
Is gallbladder disease common in Singapore?
While there is no recent research that addresses the prevalence of gallbladder disease in Singapore, Singapore General Hospital's surgical department performs approximately 400 operations to remove the gallbladder annually. [1]
What causes gallstones to form?
Stones can form in the gallbladder due to high cholesterol in the blood. In fact, most gallstones are made of cholesterol. [2]
When the blood cholesterol is too high, a crystal of cholesterol can form inside the gallbladder. From this crystal, the stone begins to form and enlarge. Multiple stones can form at the same time.
What are the symptoms of gallstone disease?
Symptoms of gallstones can range from mild to severe. Mild attacks are similar to gastric pain and flatulence. Severe attacks can be in the form of acute and intense cramps in the upper abdomen, high fever and even septic shock. [3]
Gallstones can also exist without causing symptoms. These stones are usually picked up incidentally during routine ultrasound scanning. Asymptomatic stones do not require treatment.
How is gallbladder disease treated at the symptomatic stage
Symptomatic gallstones will require surgery for a complete cure. This is because, after one attack, the chances for subsequent attacks is higher.
Surgery for gallstones involves removing the entire gallbladder and not just the stones. This is because cholesterol crystals and stones are formed on the inner lining of the gallbladder.
If only the stones are extracted, more stones will just form and the patient will suffer another attack.
How is keyhole gallstone surgery performed?
Currently, gallstone surgery can be performed via keyhole surgery. This is called Laparoscopic Cholecystectomy. [4]
Cholecystectomy or Laparoscopic Gallbladder Surgery for gallstone removal in the operating room
With special instruments and equipment, the gallbladder is carefully isolated and removed from the liver and delivered through a small incision at the umbilical area.
Removed gallbladder opened to reveal multiple cholesterol stones
With smaller incisions, the recovery is much faster. Patients are usually sufficiently well to be discharged the next day after the operation.
What happens after gallstones are removed?
An abdomen of adult Asian female patient with waterproof transparent dressing after surgery for gallstones removal
As mentioned before, patients who have had their gallbladders removed usually have minimal side effects. Most return to their normal lives with no restrictions.
Some will experience some degree of loose stool and flatulence for a month or so and then return to their normal routine of living.
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