Gallbladder

Gallbladder: Conditions and Treatment

The gallbladder is a small, pear-shaped hollow organ located on the right side of the abdomen just below the liver. The main function of the gallbladder is to store and release bile, a greenish-yellow fluid that is produced by the liver to aid in digestion. The gallbladder, along with the liver and bile ducts, make up the hepatobiliary system.

What are Some Conditions Affecting the Gallbladder?

Cholecystitis

Cholecystitis is a condition where the gallbladder becomes inflamed. It is characterized by intense pain in the upper right part of the abdomen, and may be accompanied by fever, loss of appetite and jaundice. Cholecystitis is often caused by a gallstone blocking the cystic duct. It can be acute or chronic. Gallbladder removal surgery is the most effective treatment for cholecystitis.

Gallstones

Gallstones, or cholelithiasis, are solid deposits of cholesterol or bilirubin that form in the gallbladder. They vary in number and size, and can be as small as a grain of sand or as big as a golf ball. Gallstones may block the cystic duct or bile duct causing severe pain with or without jaundice. In such cases, gallstones removal through gallbladder removal surgery is necessary. read more

Choledocholithiasis

Choledocholithiasis is when gallstones are found in the bile duct. These bile duct stones normally originate from the gallbladder and lodge themselves in the bile duct, which causes abdominal pain, jaundice, nausea and vomiting, and fever. The bile can also become infected, leading to cholangitis or biliary scarring (cirrhosis) if left untreated over the long term. Gallbladder surgery is recommended here as well to remove the source of the stones.

Gallstone Ileus

More common among the elderly aged 65 years old and above, gallstone ileus is a condition in which large gallstones (around 2.5cm) fistulate into the small intestine and cause a small bowel obstruction. This is a medical emergency that is characterized by severe abdominal pain and distension and risk of bowel perforation.

Gallbladder Empyema/Abscess

Gallbladder empyema is a condition where an infected gallbladder is accompanied by the collection of pus (an abscess), which is a collection of dead tissues, white blood cells and bacteria. It causes intense abdominal pain and fever. Gallbladder abscesses should be treated as soon as possible to prevent the infection from spreading to the other parts of the liver and other organs of the body.

Gallstone Pancreatitis

Gallbladder pancreatitis is a condition in which gallstones block the pancreas duct as they make their way down to the small intestine. This obstruction causes the pancreas to become inflamed, resulting in severe abdominal pain, fever, nausea and vomiting, and jaundice. Gallbladder surgery is advised to remove the gallstones to prevent a further episode occurring.

Perforated Gallbladder

Infection in a gallbladder can lead to a perforated gallbladder, where a hole or tear develops in the wall of the gallbladder. A perforated gallbladder is a medical emergency as there is contamination of the abdominal cavity and can be life-threatening if not treated promptly.

Gallbladder Polyps

Polyps are benign growths that can develop in the gallbladder. When small they can be observed but larger gallbladder polyps should be removed by a gallbladder surgeon in Singapore to reduce the risk of cancer developing from the polyp.

Gallbladder Cancer

Gallbladder cancer is a condition where cancer cells develop and multiply in the gallbladder. It is relatively rare, but can spread quickly if not detected and treated early. Symptoms include abdominal pain, bloating, unexplained weight loss and jaundice. Gallbladder cancer treatment involves gallbladder removal surgery that sometimes includes the removal of some parts of the liver and bile duct.

What Are the Treatments for Gallbladder Diseases?

For mild symptoms, gallbladder disease may be managed with dietary and lifestyle changes, as well as medications.

For more symptomatic or serious gallstones diseases, a gallbladder surgeon will recommend gallbladder removal surgery or cholecystectomy. This is a safe and effective way to treat the root cause of the problem. It is normally done through minimally invasive surgery, which has less pain, faster recovery and better outcomes.

In most cases, a gallbladder surgeon in Singapore will recommend gallbladder removal surgery or cholecystectomy. This is a safe and effective way to treat the root cause of the problem. It can be done through traditional open surgery or minimally invasive surgery, which promises better recovery outcomes.

Dr Wong Jen San
Consultant Hepatobiliary & Pancreatic Surgeon
MBChB (UK), MMed (S’pore), Msc (S’pore), FRCS (Edin), FAMS

Upon graduating from the University of Leicester and completing his basic surgical training in the United Kingdom, Dr Wong went on to complete advanced training in Singapore before embarking on his HMDP clinical fellowship in Japan—specializing in living donor liver transplantation.

Prior to establishing his own practice, Dr Wong was previously a consultant with the Department of Hepatopancreatobiliary & Transplant Surgery at SGH, an adjunct assistant professor at the Duke-NUS Graduate Medical School and a visiting consultant at the National Cancer Centre Singapore.

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The Hepatobiliary-Pancreatic System
is a Complex and Intricate One
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