Gallstones or cholelithiasis is the formation of stones inside the gallbladder, which affects between 15 and 25% of adult women in Spain. The gallbladder is an organ that is responsible for secreting the bile formed in the liver until it is expelled into the intestine to digest fats. When stones (also called calculi) form in the bile ducts, they are called choledocholithiasis.
Symptoms of gallstones
Gallstones are usually an asymptomatic disease; in fact, less than 20% of patients have symptoms. However, when the stones obstruct a critical area of the gallbladder, biliary colic occurs, an episode of acute pain characterized by the following symptoms:
- Nausea
- Vomiting
- abdominal pain
- Yellow skin (jaundice)
- Sudden pain
- Fever
- Tenderness to touch
Risk factors for the formation of stones in the gallbladder
There are no specific causes of gallstones, but there are hereditary factors and other conditions that increase the risk of developing them:
- Being a woman
- Obesity
- Being over 40 years old
- Pathologies such as diabetes, insufficiency of the gallbladder to empty the bile, liver cirrhosis or infections of the biliary tract.
- Hormonal or cholesterol-lowering medications
Prevention of gallstones
To reduce the risk of cholelithiasis, it is recommended to control weight (moderately, since losing weight rapidly also favors the appearance of gallstones), exercise and have a balanced diet, including:
- Monounsaturated fats: found in olive oil and in avocados and fish. Not to be confused with saturated fats, which are found in fatty meats, butter and other animal products and can increase the risk of gallstones and raise cholesterol.
- Fiber: found in whole grain bread, cereals and vegetables.
- Fruits and vegetables: it is advisable to consume abundant amounts to help prevent gallstones.
- Nuts: such as peanuts, almonds or walnuts.
- Avoid excess sugar and carbohydrates: they can cause gallstones.
- Alcohol and coffee: moderate consumption can prevent gallstones from forming.
- Vitamins: especially vitamin C, vitamin E and calcium, which decrease the risk of cholelithiasis.
Treatment of gallstones
When a patient with gallstones has no symptoms, there is much debate as to the appropriate treatment to receive. Thus, the Digestive System physician will perform a specific type of treatment depending on the patient’s condition.
If the patient does not want to undergo surgery, he/she can take tablets composed of bile acid to destroy the gallstones in the gallbladder. They can be taken both for treatment (two or three times a day) and for prevention (twice a day), but to be effective they must be taken for months.
On the other hand, when the patient suffers from the symptoms mentioned above, the most indicated technique is surgery, especially laparoscopic surgery, since, thanks to technological advances, the risks and complications are increasingly minimized.
The newest techniques are minilaparoscopy and single-port surgery, which, like conventional laparoscopy, consist of removing the gallbladder and, therefore, also the stones inside it, but with the difference of being much less invasive.
Thus, mini-laparoscopy consists of making three or four incisions of only 3 mm, while single-port surgery involves making a single incision, normally through the navel.
Since the umbilical area is painless and practically bloodless, a millimeter incision can provide a wide orifice through which to insert the instruments that will allow the gallbladder to be removed.