Liver, gallbladder, bile ducts
Although gallbladder removal is a routine operation, we always endeavor to treat this small organ and its fragile neighboring structures with great respect.
The gallbladder plays a useful, if not essential, role in our digestive system. Its main task is to store bile produced by the liver and release it into the small intestine after fatty meals as required. Bile is used to remove harmful substances from the body. It also contains enzymes that are important for fat digestion.
However, if the gallbladder causes problems, removal may be necessary. Our digestion is not restricted without a gallbladder because the liver releases most of the bile directly into the small intestine.
Which gallbladder diseases are common?
Gallstones
Gallstones form when components of the bile, such as cholesterol or bilirubin, combine to form solid particles. This process can be facilitated by various factors such as obesity, pregnancy, genetic predisposition or an unhealthy diet. Gallstones can remain in the gallbladder for years without causing symptoms. In some cases, however, they can block the bile duct and lead to painful colic. Gallstones can also lead to inflammation of the gallbladder, the bile duct and the pancreas.
As soon as gallstones cause symptoms, surgical removal makes sense. However, if they are asymptomatic, they do not require treatment.
Inflammation of the bile duct (cholangitis)
Here too, a gallstone in the common bile duct is usually the cause of the inflammation. Rarely, a tumor can also block the bile duct. If the bile no longer drains into the small intestine, this can cause inflammation with severe abdominal pain, fever, chills and jaundice (icterus).
In this situation, an ERCP (endoscopic retrograde cholangiopancreatography) is necessary. This is an endoscopic method with which the bile ducts can be visualized and blocked stones can be removed. This procedure is performed by our competent gastrointestinal specialists (gastroenterologists).
Gallbladder inflammation (cholecystitis)
If the outflow from the gallbladder is blocked (usually by a gallstone), this can lead to inflammation of the gallbladder. This can be very painful and should be treated as quickly as possible. Whenever possible, the inflamed gallbladder should be removed immediately.
Pancreatitis (inflammation of the pancreas)
Gallstones can block not only the bile ducts but also the outflow of the pancreas into the small intestine. This then leads to acute inflammation of the pancreas (pancreatitis). This is a very dangerous disease that always requires monitoring in hospital.
Are there tumors of the gallbladder?
Gallbladder polyps: Polyps are growths in the gallbladder that correspond to either benign cholesterol polyps or polypous adenomas. Diagnosis is mainly made by ultrasound examination. Adenoma polyps that are larger than 1 cm have a risk of degeneration, which is why a gallbladder removal is necessary.
Gallbladder/gall duct carcinoma: This is a malignant neoplasm of the gallbladder and/or the bile ducts. Sometimes it is found by chance in the operated gallbladder and sometimes it is the cause of jaundice. These carcinomas are very rare overall. In the case of a gallbladder or bile duct carcinoma, an interdisciplinary discussion always takes place at our tumor board in order to find the best treatment option for each individual case.
When is gallbladder surgery necessary?
In the case of recurrent biliary colic, in the case of an inflammation of the gallbladder, after an inflammation of the bile duct or pancreas caused by gallstones, or in the case of polyps >1cm, removal of the gallbladder is necessary.
How is the gallbladder examined?
After the clinical examination of the abdomen and the consultation, an ultrasound examination is always carried out. This is the best way to see gallstones. A blood sample must always be taken to diagnose inflammation. Bile ducts can be visualized using a special MRI examination (MRCP).
How is gallbladder surgery performed?
Gallbladder surgery is generally performed using minimally invasive techniques, i.e. through small incisions in the abdomen. (laparoscopy, keyhole technique). This reduces the recovery time and the risk of complications. Severely inflamed gallbladders very rarely require surgery via a large incision.
The operation takes between 30 and 60 minutes. If there is no severe inflammation, the hospital stay lasts 2 days.