Gallbladder Diseases

The gallbladder is a small, pear-shaped organ located on the underside of the liver. It stores bile produced by the liver and releases it into the small intestine during digestion of fatty foods. Stones, inflammation, and other diseases in this organ can cause abdominal pain, indigestion, and serious complications.

Gallbladder Anatomy and Function

The gallbladder is a 7-10 cm long organ located on the right lower surface of the liver, just below the ribs.

Functions:

Stores bile produced by the liver
Concentrates bile
Releases bile into the small intestine when fatty food is eaten
Provides absorption of fats and fat-soluble vitamins (A, D, E, K)

Life is possible without a gallbladder. When removed, the liver continues its function by sending bile directly to the small intestine.

Types of Gallbladder Diseases

Gallstones (Cholelithiasis)

The most common gallbladder disease. Seen in approximately 10-15% of the population.

Stone types:

Cholesterol stones: Most common type (80%), yellow-green colored
Pigment stones: Small, dark stones containing bilirubin
Mixed stones: Contain both cholesterol and pigment

Acute Cholecystitis (Gallbladder Inflammation)

Acute inflammation of the gallbladder, usually developing as a result of a stone blocking the cystic duct.

Symptoms:

Severe pain in the right upper abdomen
Pain radiating to right shoulder or back
Nausea and vomiting
Fever and chills
Loss of appetite

Chronic Cholecystitis

Wall thickening and loss of function as a result of recurrent inflammation attacks. Manifests with recurrent pain after fatty foods, bloating, and indigestion.

Choledocholithiasis (Common Bile Duct Stones)

Stones that have passed from the gallbladder to the common bile duct. May lead to jaundice, light-colored stool, dark-colored urine, and severe abdominal pain.

Gallbladder Polyps

Masses developing from the gallbladder wall. Most are benign. Surgery is considered for polyps larger than 1 cm.

Gallbladder Cancer

A rare but aggressive type of cancer. Chronic cholecystitis and gallstone history are risk factors.

Symptoms of Gallbladder Diseases

Biliary Colic (Classic Gallbladder Pain)

In the right upper abdomen or mid-upper abdomen
Radiates to back or right shoulder
Begins after fatty foods
Lasts 30 minutes to several hours
Usually occurs at night or after meals

Other Symptoms

Nausea and vomiting
Indigestion and bloating
Belching
Intolerance to fatty foods

Symptoms Requiring Urgent Intervention

Severe and persistent abdominal pain
High fever and chills
Jaundice
Light-colored stool, dark-colored urine

Risk Factors

The "5 Fs" rule for gallbladder diseases:

Female: 2-3 times more common in women
Fat: Obesity is an important risk factor
Forty: Risk increases over age 40
Fertile: Pregnancy and number of births
Fair: More common in white race

Other risk factors: Genetic predisposition, rapid weight loss, birth control pills, diabetes, high cholesterol, sedentary lifestyle, fatty and low-fiber diet.

Diagnostic Methods

Abdominal Ultrasound

The gold standard diagnostic method. Fast, safe, and detects gallstones with over 95% accuracy. Can be safely used during pregnancy.

MR Cholangiography (MRCP)

Detailed, non-invasive imaging of bile ducts.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

Provides both diagnostic and therapeutic options. Used in removal of common bile duct stones.

Blood Tests

Liver function tests, CRP, complete blood count, amylase, and lipase are evaluated.

Treatment Methods

Observation

Observation may be recommended in asymptomatic gallstones.

Medication Treatment

Ursodeoxycholic acid can dissolve cholesterol stones but success rate is limited (30-40%) and takes months.

Laparoscopic Cholecystectomy

Currently the gold standard surgical method:

3-4 small incisions (5-10 mm)
Camera imaging
General anesthesia
Operation duration: 45-60 minutes
Hospital stay: 1-2 days
Return to work: 1-2 weeks

Advantages: Less post-operative pain, fast recovery, smaller scars, short hospital stay.

Open Cholecystectomy

Preferred in complex cases, adhesions, or severe inflammation. Recovery time is 4-6 weeks.

Stone Removal with ERCP

If there is a stone in the common bile duct, stones are removed endoscopically before or during surgery.

Acute Cholecystitis Treatment

Antibiotic therapy
Intravenous fluid replacement
Pain control
Early laparoscopic cholecystectomy (within first 72 hours)

Post-Operative Process

Mild pain is normal in the first week, managed with painkillers
Wound care is important
Sports can be started after 2-4 weeks
Full recovery takes 4-6 weeks
Gradual transition to fatty foods
Most patients return to normal life

Possible Complications

Bleeding
Wound infection
Bile duct injury (0.3-0.5%)
Bile leakage
Post-cholecystectomy syndrome

In untreated disease: Acute cholecystitis, perforation, pancreatitis, cholangitis may develop.

Prevention Methods

Fiber-rich food consumption
Healthy fats (olive oil, fish)
Avoiding fatty, fried foods
Healthy weight control
Regular physical activity
Avoiding rapid weight loss methods
Regular and balanced meals

FAQ

Yes. Approximately 90% of patients return to normal life without any problems. The liver sends bile directly to the small intestine.

Some cholesterol stones can be dissolved with ursodeoxycholic acid, but the success rate is around 30-40%. Stones may reform when treatment is stopped. Surgical treatment is preferred in most cases.

For the first 1-2 weeks, fat-free, light foods are preferred. Then a gradual transition to normal diet is made. In the long term, balanced and fiber-rich nutrition is recommended.

Laparoscopic cholecystectomy can be safely performed in the second trimester (months 4-6). Surgery is preferred when conservative treatment fails.

The risk of cancer slightly increases in patients with long-term gallstones (especially larger than 3 cm). Early treatment of symptomatic stones reduces this risk.