The gallbladder is a pear-shaped organ that lies below the liver. One of the jobs of the liver is to make bile that passes down the bile duct to mix with food in the small intestine, and aid in digestion. Some of this bile is diverted to the gallbladder for storage. When food, particularly fatty food travel thought the gut, the gallbladder contracts in order to squeeze out some bile into the gut to further facilitate digestion.
The gallbladder can make stones. If these roll around freely inside the gallbladder then there is no problem. However, if a stone happens to lodge in the outflow tract of the gallbladder, the gallbladder contracts, but as it is blocked, significant pain can result. If the stones fall back out, then this is called biliary colic, and the pain resolves. If the stone remains stuck, then an infection called cholecystitis can develop, and the pain persists.
Also, the stones can fall all the way out of the gallbladder and block the duct between the liver and the intestine, or can lodge in other places like the nearby pancreas. These can both cause major problems and can be more dangerous than stones left in the gallbladder.
In general, if you have had any of the above problems, then the gallbladder should be removed, stones and all. There’s no point in removing just the stones as they will reform. Some people are too frail from other reasons to have surgery to remove the gallbladder – they can be treated with medications to dissolve the stones, but these medications don’t work very well and have significant side-effects and therefore are not as good as surgery.
These days, the gallbladder is usually removed via keyhole (“laparoscopic”) surgery, called laparoscopic cholecystectomy. Four small incisions are made in the abdomen and the gallbladder is removed through the belly-button. Recovery is usually rapid and normally only one night is spent in hospital.
A new variation of this surgery is called “single-incision laparoscopic cholecystectomy”. Here, a single incision is made, and buried in the belly-button. This makes it very difficult to ever see the scar after the operation, and can give very good cosmetic results. Not all patients are suitable for single incision gallbladder surgery, so please ask your doctor if it might be right for you.
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