Did you know that every fatty food you eat goes to the gallbladder?
It is evident that there is fat even in a small cracker or biscuit that we put in our mouths, not just in meals. While the stomach mixes this food, it sends a message to the gallbladder via hormones. The gallbladder then releases this fluid, which it is mixing, through strong contractions via an opening called the papilla into your duodenum.
Starting from the liver and ending in your duodenum, this highway is also connected by a side road from your pancreas. The pancreas adds the digestive enzymes necessary for nutrient absorption to the main bile duct through this side road. The pile of fatty food that has reached the duodenum is enveloped here by bile fluid. Bile makes the fats in this mixture absorbable by dissolving them. Subsequently, they are absorbed by our intestines and sent to the liver for processing.
Bile sludge is quite dangerous!
It is evident that the stones or sludge found in the gallbladder during the normal functioning of our body have the potential to cause problems. While draining bile from the gallbladder into the ducts, with the effect of contractions, stones or sludge can detach and flow into these ducts. Contrary to popular belief, small stones or sludge are more dangerous than large stones. They can block your bile ducts, leading to jaundice and inflammation. Even worse, if they manage to enter the pancreatic duct that connects to the main duct, they can cause a much more dangerous condition known as pancreatitis, or inflammation of the pancreas.
Large stones can pose risks such as gallbladder inflammation, gallbladder gangrene, and gallbladder perforation.
Don’t think “I overate” every time you have pain!
Considering that the frequency of gallstones and sludge can reach around 10% according to some studies conducted in society, many patients mentioned above seek help from doctors or emergency services.
Some gallstones are silent. They can remain silent for years without causing any complaints. They will only cause mild stomach pain, bloating, abdominal and back pain when you consume fatty foods, eggs, or olives. When it is short and transient, you will often think that you have overeaten. However, remember that as you consume fatty foods, your gallbladder will contract, and with each contraction, these stones will try to enter the duct. They will wait inside the gallbladder as a potential risk.
If you are complaining about bile and stones…
If you have gallstones or sludge causing complaints, your gallbladder must be completely removed surgically. There is no surgical method that only removes the stones and leaves the gallbladder. Even if there were, stones and sludge would form again inside the gallbladder. The risks mentioned above can occur with mobile gallstones and sludge. Nowadays, both open and laparoscopic methods are used. In cases of gallbladder inflammation, even if the closed method is used to enter the abdomen, the anatomy can be quite complicated due to adhesions and inflammation. Therefore, a decision may be made to proceed with open surgery. Laparoscopic surgery is a method that requires a one-day hospitalization, allowing you to return to normal life quite quickly. In open surgeries, however, the healing of the gallbladder takes a long time; sometimes drainage is required; and there are higher risks of infection and hernia compared to closed surgery.
Medication treatment must be waited for 6-8 weeks before surgery
When you go to the emergency room, the type of surgery selection is very important. In the first 24 hours when pain and other complaints begin, the adhesions inside the abdomen have not yet matured, so your chances of having laparoscopic surgery are high. However, as time passes, the adhesions and anatomical chaos inside will mature, reducing your chances of laparoscopic surgery. Even if it is done laparoscopically, there is a possibility of having to convert to open surgery. In such cases, the best choice should be to wait for 6-8 weeks with medication treatments and monitoring to allow the infections and adhesions inside to improve, and then plan laparoscopic surgery to safely remove your gallbladder.
Stones and sludge in the bile can be cleaned with endoscopy before surgery
In cases of gallbladder pain and complaints, many tests such as AST, ALT, ALP, GGT, Total Bilirubin, Direct Bilirubin, and Amylase are checked from the blood. Each of these blood tests indicates a problem at a specific point in the intrahepatic or extrahepatic bile ducts or the pancreatic duct. Based on these test results, the blockage area and degree are determined, and your treatments are applied. Sometimes, when stones and sludge are detected in the bile duct, immediate surgery cannot be performed. First, a type of endoscopy called ERCP, performed under sedation, is used to clean the stones and sludge from the ducts. After that, your gallbladder can be removed surgically.
