– As for, kind of, 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, the
food is also released,
the pancreatic enzymes are 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 gallstones related disease
is that when the gallbladder contracts,
the stones 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 in the right upper quadrant,
some people feel it
radiating to their back.
When it’s 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 diagnostics tool
to evaluate the gallbladder
for gallbladder wall
thickness, for gallstones.
If that study is negative
and you still have gallbladder type pain,
the next step would be 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
for removal of the gallbladder
through four small incisions
and a little camera and
a little instrument.
It is considered outpatient surgery,
you come in get your surgery then,
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 to have to
make any dietary changes.
80% of people can go back to
eating anything they want.
There’s 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 will still be able to
make the bile you need.
Instead of it being
stored in the gallbladder,
it’ll then travel down the main bile duct
from the liver into the intestine
so that you will still have the
bile you need for digestion.
Right now, this is one of the most
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
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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Dr. C. Reese Davis, MD, practicing at St. Mark’s Hospital, talks about the purpose of the gallbladder, the causes of gall stones, and the treatment of gallbladder problems.