Common Gallbladder Conditions

The gallbladder is a small, pear-shaped organ that is located under the liver. It stores and releases bile, which aids in digesting the fats present in food. The gallbladder can be affected by medical conditions associated with age, diet, high cholesterol, obesity and others.

One of the most common gallbladder diseases in Singapore are gallstones, which can block the bile duct or the pancreas and cause intense pain and infection. Gallstones are typically addressed by removing the gallbladder and the gallstones within entirely.

Who Does Gallbladder Disease Affect?

Gallbladder diseases are more likely to happen to those who are:

60 years old and older (Younger in females)
consume food with high cholesterol, high fat and oil content
pregnant due to extra levels of oestrogen, which increases cholesterol levels
overweight or obese
have a family history of gallbladder diseases or gallstones

What are Common Gallbladder Conditions?

Cholecystitis: This is the inflammation and infection of the gallbladder resulting from a build-up of bile caused by gallstones blocking the tube leading out of the gallbladder. Some of its symptoms include a sharp pain in the abdomen that spreads toward the right shoulder, fever and nausea
Gallstones: These are solid deposits of bile fluid that develop in the gallbladder over time. The sizes of gallstones can range from a small grain to a golf ball. They do not cause symptoms until they cause blockage, which will result in pain.Once they form, medications and diet modifications are not effective . However, those that do cause persistent and intense pain or frequent symptoms such as bloatedness or discomfort will require gallbladder surgery.
Chronic acalculous gallbladder disease: This condition refers to problems such as inflammation of the gallbladder without gallstones. Chronic acalculous gallbladder disease can be a result of complications from other health problems such as starvation, long-term illness. Upper abdominal pain/ discomfort that is sudden and intense or persistent is one of its common symptoms.
Gangrene or abscess: This refers to the death of tissues brought on by an intense bacterial infection or an inadequate amount of blood flow. Gangrene can affect internal organs such as the gallbladder in severe infections. These are more frequent and can be silent in people with Diabetes.
Growths of tissue in the gallbladder: Polyps or abnormal growths of tissues inside the mucous lining of the gallbladder are usually benign and might be an indicator of other gallbladder problems. They can cause inflammation and have a small chance of becoming cancerous over time especially in patients with a strong family history of cancer . Surgery is required if the patient presents with symptoms of the growth is deemed to be suspicious or at risk of harbouring cancer.
Tumours of the gallbladder and bile ducts: Tumours can form in the bile duct and gallbladder that can cause extrahepatic biliary obstruction or the blockage of the normal flow of bile from the liver to the intestinal tract. One of the primary causes of this condition is gallstones.
Biliary dyskinesia: This is a functional gallbladder disorder that affects the motility of the gallbladder, or its ability to move bile out into the bile ducts. Biliary dyskinesia can sometimes affect the sphincter, which is the small muscle located where the bile channel empties into the intestine. When the gallbladder fails to move bile out into the bile ducts normally, the collection of bile can cause the gallbladder to become swollen or fuller.

What are Common Signs and Symptoms of Gallbladder Problems?

Gallbladder problems are different, yet they share common symptoms such as:

abdominal pain, specifically in the upper right abdomen
bloatedness, indigestion, abdominal discomfort
vomiting and nausea
fever or chills or rigors
jaundice, or yellow-tinted skin and eyes
tea coloured or dark urine
chronic diarrhoea or oily stools
light-coloured pale stools

How are Gallbladder Problems Diagnosed?

A doctor may administer the following tests to identify the condition:

Liver function test (LFT): Done via blood tests, they may present evidence of gallbladder disease or bile blockage, jaundice etc
FBC: A full blood count can identify if there is an infection e.g., higher white blood cell count. Other blood tests can also show If there are associated complications such a pancreas inflammation or liver abscesses.
Ultrasound: This produces clear images of the gallbladder, liver and bile ducts, allowing doctors to detect gallstones, tumours, fatty liver, scarring and inflammation.
Computed tomography (CT)/ Magnatic Resonance Imaging (MRI) scan: These cross-sectional scans produces images of the pancreas, gallbladder, liver and bile ducts. It can also reveal gallstones and blockages in the bile ducts and guide treatment.
HIDA scan: This helps determine how well the gallbladder and liver are functioning.

How is Gallbladder Disease Treated?

Patients who are diagnosed with asymptomatic gallbladder disease generally do not require treatment, as the condition is benign and usually do not cause significant complications.. However, those who present with mild to moderate symptoms or these become more frequent, may need to seek a consultation and embark on treatment if is deemed necessary before it becomes more serious.

In more serious cases where symptoms are present, frequent, severe and persistent, it may be addressed by removing the gallbladder. People can live full, normal and healthy lives without a gallbladder. The liver will continue to produce bile for digestion, but instead of some being stored into the gallbladder, more of the bile will flow directly into the small intestine. Once the gallbladder is unhealthy, keeping it confers more risks than benefits.

A keyhole surgery, laparoscopic cholecystectomy is the procedure of choice for removal of the gallbladder. It is very safe and routine. The surgery is performed under general anaesthesia through 3-4 small cuts in the abdomen. The gallbladder is detached from the liver and clips are applied to the artery that supplies the gallbladder and the duct that drains from it. The gallbladder is then removed in a bag through one of the incisions.

As the incisions are small (3-5mm) with minimal pain and downtime, this can be performed as day surgery in most patients.

Surgical Associates specialises in laparoscopic and robotic surgery for the treatment for gallbladder, pancreas and liver conditions. Call 6454 0054 today to schedule an appointment or learn more here - www.gallstones.sg