GallBladder is a pear-shaped accessory digestive organ tucked under the liver in the right upper abdomen. The function of the Gall Bladder is primarily storing the bile juice which is produced by the liver; when we eat fatty food the gall bladder squeezes this bile through the common bile duct into the intestine. When cholesterol or fat concentration increases in the bile juice, the juice precipitates as stone in the Gall Bladder. It can occur in all age groups and in both sexes, though more commonly in females.
Surgical removal of the gallbladder also known as cholecystectomy is the most effective way to remove all the gallstones and mitigate its recurrence. Previously surgery was done by making an incision on the right upper abdomen,.but now the surgery is done with minimal invasive approach (laparoscopic technique)
Currently the gold standard treatment for gall stones is ‘Laparoscopic Cholecystectomy’ under general anaesthesia. It is a safe procedure that involves 4 small holes only. It can also be done as a Single incision Laparoscopic surgery (SILS)
CBD stones are stones with in the bile duct. These stones are usually formed inside the Gallbladder although at times they may form in the bile ducts even after gallbladder removal. The stones formed in the gallbladder may spill in the bile duct anytime due to gallbladder contraction.
Common symptoms associated with CBD stones are Pain in the upper abdomen or back, jaundice, vomiting and fever. These stones have to be removed at the earliest once identified in most of the cases.
Traditionally open CBD exploration was the method of choice for removal of these stones. Nowadays most of these stones can be removed endoscopically by ERCP in a day care setting without any scar on the body. Early Gallbladder removal by laparoscopic surgery should follow the CBD clearance (ERCP) to prevent re-spillage of stones in the CBD.
For stones which are big in size and rarely for various anatomical reasons, it may not be possible to remove / clear the CBD endoscopically. Laparoscopic CBD exploration and clearance is the procedure of choice for in such cases. By this technique CBD clearance and gallbladder removal can be done in single sitting thus avoiding two procedures with a shorter hospital stay.
