Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Gallstones

Gallstones

What are Gallstones?

Gallstones are small, pebble-like, stone particles of cholesterol or calcium salts that form from bile in the gallbladder. The gallbladder is located just below the liver in the upper right abdomen; it looks like a pear-shaped sac. Gallstones form from bile which is a liquid water-like substance that is made up of cells from the liver used for digesting food and can developed within the gallbladder or in the nearby bile ducts. Gallstones can developed into any variety of sizes and the sizes can vary from as small as a grain of sand to a golf ball. Although gallstones found in the gallbladder may not cause immediate problems they may produce discomfort when certain foods are ingested. More serious cases of gallstones could lead to inflammation and severe abdominal pain and can be life threatening if the pancreas becomes inflamed causing damage.

What are the symptoms of Gallstones?

Most cases of gallstones are unknown to the patient until discovered by a doctor. The condition shows almost no signs or symptoms but as the gallstones move into the bile ducts they can create blockage and increase pressure inside the gallbladder causing problems. This usually leads to the first signs and symptoms of gallstones:

  • Chronic indigestion
  • Upper abdominal pain
  • Nausea and vomiting
  • Fever/chills
  • Intolerance of fatty, greasy foods
  • Jaundice (in severe cases)
  • Clay-colored stools

How are gallstones diagnosed?

  • Computerized tomography (CT) scan
  • Cholescintigraphy (HIDA scan)
  • Endoscopic retrograde cholangio-pancreatography (ERCP)
  • Blood test (to look for infection)
  • Ultrasonography

How are gallstones treated?

Although there is no cure to prevent gallstones formation, there are several treatment options that include surgical or non surgical options.

Surgery can remove the gallbladder completely (called cholecystemctomy) especially in patients that have severe or chronic gallstone complications. Cholecystemctomy can be performed by laparoscopic surgery – the use of a laparoscope, a tiny tube lighted video camera and a cannula and to remove the gallbladder through a small incision. Another option is through open surgery which will remove the gallbladder through a larger abdominal incision. In extreme cases where the gallbladder needs to be removed immediately the surgeon may only have the latter option.

Non-surgical treatments have more options:

  • Oral dissolution therapy or bile salt tablets used to dissolve small cholesterol stones
  • Sound wave therapy uses high-frequency sound waves to destroy gallstones followed by ursodiol (bile) tablets to dissolve remaining fragments
  • Percutaneous electro-hydraulic lithotripsy will use a catheter containing a small probe to send bursts of energy to destroy gallstones
  • Topical gallstone dissolution utilizes a catheter to inject a solution that will dissolve the cholesterol gallstones in the gallbladder

What are the risk factors for Gallstones?

  • Females are at high risk for developing gallstones
  • Obesity or overweight
  • Rapid weight loss
  • Age
  • Increased levels of cholesterol in the blood
  • Diets high in fat content in combination of high cholesterol
  • Family history
  • Patients with Diabetes