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Cholecystitis

cholecystitis

Bile is a fluid made in the liver. Bile contains various substances, including bile pigments, bile salts, cholesterol and lecithin. Bile is passed into tiny tubes called bile ducts. The bile ducts join together (like the branches of a tree) to form the main bile duct. Bile constantly drips down the bile ducts, into the main bile duct, and then into the gut.

The gallbladder lies under the liver on the right side of the upper abdomen. It is like a pouch which comes off the main bile duct and fills with bile. It is a 'reservoir' which stores bile. The gallbladder contracts (squeezes) when we eat. This empties the stored bile back into the main bile duct. The bile passes along the remainder of the bile duct into the duodenum (the first part of the gut after the stomach).

Cholecystitis means inflammation of the gallbladder.

What are the symptoms of cholecystitis?

  • Pain in the upper abdomen is the main symptom. It is usually worse on the right side under the ribs. The pain may radiate (travel) to the back or to the right shoulder. The pain tends to be worse if you breathe in deeply.
  • You may also develop nausea (feeling sick), vomiting and a fever (high temperature).

What causes cholecystitis?

Most cases of cholecystitis are caused by gallstones.

How is cholecystitis diagnosed?

An ultrasound scan is commonly done to clarify the diagnosis. This is a painless test which uses sound waves to scan the abdomen.

What is the treatment for cholecystitis?

You will normally be admitted to hospital. Usually, you will not be allowed to eat or drink (to rest the gallbladder), and you will be given fluids and painkillers directly into a vein through a 'drip'. If the doctor suspects that the gallbladder has become infected, you will also be given antibiotics directly into a vein.

The gallbladder will usually be removed by an operation. The operation is often done within a few days of being admitted to hospital. Sometimes the operation is delayed for several weeks until the inflammation has settled.

Keyhole surgery is now the most common way to remove a gallbladder. The medical term for this operation is laparoscopic cholecystectomy. It is called keyhole surgery as only small cuts are needed in the abdomen with small scars remaining afterwards. The operation is done with the aid of a special telescope that is pushed into the abdomen through one small cut.

This allows the surgeon to see the gallbladder. Instruments pushed through another small cut are used to cut out and remove the gallbladder. Keyhole surgery is not suitable for all people.

Some people need a traditional operation to remove the gallbladder. This is called cholecystectomy. In this operation a larger cut is needed to get at the gallbladder.

What are the possible complications of cholecystitis?

If treatment is delayed or not available, in some cases the gallbladder becomes severely infected and even gangrenous. Other possible complications include: the gallbladder may perforate (burst), or a fistula (channel) may form between the gallbladder and gut as a result of continued inflammation.

After a gallbladder is removed.

You do not need a gallbladder to digest food. Bile still flows from the liver to the gut once the gallbladder is removed.
You can usually eat a normal diet without any problems after your gallbladder is removed. However, up to half of people who have had their gallbladder removed have some mild abdominal pain or bloating from time to time. This may be more noticeable after eating a fatty meal.


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