Gallbladder and Its Function

The gallbladder is a small pear-shaped organ located beneath the right lobe of the liver. Pain related to gallbladder disease is usually felt in the right upper abdomen.

The liver produces bile which is stored in the gallbladder. Bile helps in the digestion of fats.

After gallbladder removal, bile flows directly from the liver into the intestine. The body gradually adapts, and fat digestion becomes normal within 4–6 months.

Gallstones

Gallstones are very common. The exact cause of gallstone formation is not fully understood and there is no proven method for prevention.

There is no specific diet that prevents gallstone formation.

Symptoms

• Right upper abdominal pain
• Nausea and vomiting
• Indigestion
• Fat intolerance

Stones impacted in the gallbladder neck may cause gallbladder swelling (mucocele). Infection may lead to pus formation (pyocele), which requires urgent treatment.

Diagnosis

• Ultrasound abdomen (best test)
• Detection of CBD stones
• CBD dilatation assessment
• Pancreatitis evaluation
• MRCP in suspected CBD stones

Ultrasound is the most sensitive investigation for detecting gallstones, often better than CT scan.

Gallstone Treatment

There is no effective medicine or alternative therapy for permanent treatment of gallstones.

The recommended treatment is Laparoscopic Cholecystectomy, in which the entire gallbladder is removed using minimally invasive surgery.

• Day-care surgery
• Small incisions
• Minimal pain
• Early discharge
• Normal activity next day

Surgery is often recommended even in asymptomatic patients due to possible complications such as:

• Jaundice
• Cholangitis
• Pancreatitis
• Gallbladder cancer

After surgery, patients are advised to avoid excessive fatty foods for 2–3 months.

Estimated Surgery Cost:
₹40,000 – ₹90,000 (varies by hospital and room category)

Gallbladder Cancer

Gallbladder cancer is relatively common in North India. Patients usually present with pain in the right upper abdomen.

Symptoms

• Right upper abdominal pain
• Loss of appetite
• Weight loss
• Jaundice
• Vomiting

Jaundice and vomiting usually occur when the tumor spreads to nearby organs.

Diagnosis

• Ultrasound abdomen
• CT scan abdomen
• MRCP in jaundice patients
• Upper GI endoscopy if required

FNAC is generally avoided because it may spread tumor cells along the needle tract.

Surgical Treatment

Surgery is the primary treatment when gallbladder cancer is operable and the patient is fit for surgery.

• Staging laparoscopy
• Radical cholecystectomy
• Liver segment IVB and V resection
• Lymph node dissection

If cystic duct margin is positive, bile duct removal and reconstruction may be required.

Locally advanced tumors may require removal of involved organs along with the gallbladder.

Pre-operative biliary drainage may be required in patients with jaundice before major surgery.