Gallstone removal / Gallbladder surgery

What causes gallstones?

A gallstone is formed by bile fluid and arises from an imbalance of the soluble components of bile. Gallstones can either be located directly in the gallbladder or in the main gallbladder duct.

10 to 15% of adults carry gallstones. Women are twice as likely to be affected as men. A familial tendency can also be a cause of gallstones.

Other risk factors and causes for gallstones include:

• Overweight
• High-fat diet
• Diabetes mellitus
• Hypercholesterolemia (elevated cholesterol levels)
• Crohn's disease (inflammatory bowel disease)

Gallstones – symptoms

In only one quarter of the cases do gallstones cause symptoms or discomforts – and only then should they be treated. The following symptoms can indicate gallstones:

• Painful cramps in the abdomen (colics) – especially after eating fatty or spicy food
• Pain in the upper abdomen extending to the back or right shoulder
• Jaundice (due to blockage of the bile ducts)
• Brownish discoloration of the urine
• Light-colored stool
• Elevated liver values
• Pancreatitis

If you complain of gallbladder pain or show the mentioned symptoms of gallstones, do not hesitate to consult a specialist for gallstones.

Gallbladder – removal (cholecystectomy)

There are different ways to treat gallstones. In most cases, entire gallbladder removal through a cholecystectomy is advised. As a specialist with many years of experience in treating gallstones, Dr. med. Andreas Franczak can offer you the treatment methods that are best for your individual diagnosis.

Gallbladder removal – cholecystectomy with Keyhole Technique

To prevent the recurrence of gallstones, the therapy of choice is the removal of the gallbladder. Humans can live without any restrictions even without a gallbladder. The gallstone surgery with the keyhole technique (laparoscopic cholecystectomy) is minimally invasive and is performed under gentle general anesthesia. The following methods are available to remove gallbladders:

• Through a single access in the navel (SILS – single incision laparoscopic surgery) – practically without any remaining scar.
• In the micro-laparoscopic method (two 3mm accesses and one 12mm navel access) - practically without any remaining scar.
• In the rarest cases, gallstone surgery is performed conventionally (through abdominal incision).

Gallbladder removal – cholecystectomy as a therapeutic splitting

If there are stones in the bile duct (cholecystolithiasis) therapeutic splitting is performed to remove gallstones and the gallbladder: First, the stones are endoscopically removed from the bile duct (like during a gastroscopy) with the endoscopic retrograde cholangiography and pancreatography (ERCP) and, if necessary, papillotomy (opening of the junction of the bile duct into the duodenum). Subsequently, the SILS or laparoscopic gallbladder removal is completed. Complications occur in less than 1% of surgeries with experienced surgeons.

What Complications Can Gallstones Cause?

• Gallbladder inflammation (cholecystitis)
• Peritonitis (in acute cases)
• Biliary pancreatitis
• Excessive dilation of the gallbladder (gallbladder hydrops)
• Porcelain gallbladder (in chronic inflammation)
• Gallbladder cancer (cholangiocarcinoma)
• Intestinal obstruction (gallstone ileus)

In some cases, these complications can lead to life-threatening situations. Therefore, it is advisable to always consult a specialist to professionally evaluate the symptoms and possibilities of gallbladder removal.

Gallensteine FAQ, Häufig gestellten Fragen