cholecystolithiasis is the term used for the presence of gallstones within the gallbladder. NHS choices (2012) highlights gallstones as the most common cause of emergency hospital admission for people with abdominal pain. Every year the NHS performs more than 60,000 gallbladder removals in the UK. The medical term for the surgical removal of the gallbladder is a cholecystectomy. As cholecystolithiasis is the most common cause of abdominal pain, I have chosen this as the subject of my essay.
The gallbladder is a small storage vessel for bile, and is attached to the underside of the liver and above the small intestine. The bile is a greenish brown alkaline fluid secreted by the liver and concentrated in the gallbladder. According to MedlinePlus (2014) bile contains mostly cholesterol, bile salts, bilirubin, water and electrolytes. As the stomach releases its contents into the small intestine, it stimulates the gallbladder in response to the vagus nerve activity produced when foods are passed from the stomach. Causing it to release bile through the bile duct into the duodenum. The bile keeps the intestine’s contents at an appropriate pH for digestion, and to help break down fats for further digestion. Gale Encyclopedia of Medicine (2008)
Duxbury, M and Parks, R (2011) suggest gallstones form as a result of abnormalities in metabolism, infection and bile equilibrium. Imbalances in the cholesterol and bile acid levels can lead to cholesterol crystal precipitation, which act like a nucleus around which gallstones can form. There are 2 main types of gallstone, cholesterol and pigment, and they are classified according to their main constituents. Cholesterol stones being by far the most common. Gallstones can vary in size from 1 to 30mm, and may exist singularly or as multiples. Many people who have gallstones, never suffer any symptoms, and discover the condition incidentally whilst diagnostic procedures being performed for other reasons. Hibberts, F and Carapeti, E (2005) draw attention to the symptoms, that occur when stones become dislodged and block the cystic or bile duct, preventing the bile from reaching the duodenum and causing inflammation. These can include feeling and being sick, sudden intense abdominal pains, and jaundice.
There are non-surgical ways to eliminate gallstones, but they are often ineffective. For most people with acute symptoms, removal of their gallbladder is recommended. The procedure is known as a cholecystectomy, and can be performed laparoscopically. This is the favoured technique, the reasons highlighted by MedicineNet.com (2014) are, a shorter hospital stay, and recovery, less pain, a small scar and a faster return to work. The surgery, known also as keyhole surgery, is minimally invasive and often carried out as a day case. The patient, when anaesthetised is intubated and placed in a supine position, often with the head slightly downward, to increase the space in the abdominal cavity. Carrie,L....