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Surgical Treatment of Gallstone Disease (GSD)

Gallstone disease (GSD) is a condition characterized by the formation of stones in the gallbladder and hepatic ducts. The exact cause of this pathology is not fully understood, but several factors are identified that increase the risk of developing GSD:

Gender (more common in women)
Age (gallstones are found in 30% of individuals over 70 years old)
Obesity
Poor diet (high-fat foods)
Congenital anomalies of the hepatic ducts and gallbladder
Past or chronic liver diseases
Changes in bile composition
Hereditary factors
Impaired bile flow due to tumor compression

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Symptoms of Gallstone Disease

The formation of gallstones occurs gradually, and the speed of this process depends on many external and internal factors. Initially, the disease develops asymptomatically, and the first signs appear when the stone becomes a mechanical obstruction to bile flow. Symptoms of GSD include:

Jaundice
Pain in the right upper quadrant of the abdomen
Biliary colic attacks
Light-colored and soft stools
Increased flatulence
Coated tongue
Bitter taste in the mouth
General weakness
Nausea and vomiting

The manifestations of GSD vary in intensity and depend on the size of the stone. If there is a complete blockage of bile flow, gradual intoxication develops, body temperature rises, and severe pain occurs.

Complications of Gallstone Disease

Without proper diagnosis and treatment, gallstones continue to grow, leading to serious complications. The consequences of impaired bile flow include:

Acute cholecystitis: Stones may press on the walls of the gallbladder and cause injury, leading to an inflammatory process. This is accompanied by symptoms such as sharp pain, fever, and general malaise. If not treated in time, a rupture of the gallbladder wall can occur, leading to peritonitis, which is life-threatening.
Mechanical jaundice: Bile is necessary for fat digestion and absorption, and it also gives the stool its normal color (brown). Stones obstruct bile flow, causing yellow skin, itching, white stools, and dark urine. Prolonged jaundice leads to intoxication.
Cholangitis: As with cholecystitis, stones cause inflammation in the bile ducts, which affects liver function.
Cirrhosis of the liver: Chronic infection and bile stasis negatively impact liver function, causing irreversible changes in the glandular tissue structure.
Pancreatitis: The pancreatic duct joins the common bile duct before opening into the duodenum. Stones can obstruct the flow of both bile and pancreatic enzymes, leading to their accumulation in the pancreas and causing pancreatitis.

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When Is Surgical Treatment Necessary for GSD?

The appearance of symptoms in GSD indicates the progression of the disease and the need for treatment. In the early stages, conservative therapy, including medications to thin bile, reduce cholesterol concentration, hepatoprotectors, etc., can be used. Direct indications for surgical treatment of GSD include:

Presence of acute or chronic calculous cholecystitis
Intense biliary colic
Development of pancreatitis
Stones larger than 15 mm in diameter
Multiple gallstones filling half of the gallbladder
Choledocholithiasis
Suspected gallbladder cancer
Gallbladder wall rupture

The best choice for surgical treatment of GSD is laparoscopic surgery. During this procedure, the gallbladder and stones are completely removed through small incisions in the abdominal wall.

Diagnosis and Preparation for Surgery

If you experience the first symptoms of GSD, consult a gastroenterologist at the "Helyos" clinic. The specialist will listen to your complaints, perform a general examination, percussion, and palpation, and then refer you for additional tests to confirm the presence of GSD. Diagnostic procedures include:

Abdominal ultrasound: The primary method for detecting stones, determining their volume, shape, and location. Ultrasound can diagnose the early stages of GSD when bile begins to thicken.
Laboratory tests: Blood tests, including biochemical and general blood tests, help identify inflammation, cholesterol, bilirubin levels, and more.
Cholangiopancreatography: Examination of the bile ducts and pancreas using contrast agents.
CT and MRI for confirming the diagnosis.

Based on the results of these additional diagnostic methods, the final diagnosis is made, and the treatment method is chosen. If surgery is required, the doctor will determine the date and time of the procedure. Laparoscopic cholecystectomy does not require special preparation from the patient since it is a minimally invasive procedure. However, there are several rules to follow for successful treatment:

A few days before the procedure, avoid consuming fatty, spicy, fried, and high-calorie foods, as well as alcohol, to ease digestion and relieve the intestines.
The surgery is performed on an empty stomach; you should eat no later than 7:00 PM the day before the procedure.
Perform a cleansing enema in the evening and before the surgery.
Coordinate with your doctor if you regularly take any medications.

Immediately before the surgery, the medical staff will check vital health indicators and, if necessary, make adjustments (e.g., normalizing blood pressure or correcting hemostasis).

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Why Choose the "Heyios" Medical Center?

The "Helyos" Medical Center is equipped with state-of-the-art medical equipment for successfully performing surgeries of any complexity. Our doctors use a comprehensive and individual approach to each patient, conduct thorough diagnostics, and select the most effective treatment methods. In the "Helyos" clinic in Dnipro, experienced top-level doctors use the latest techniques and achieve the best results in treating gallstone disease. Each room in the medical center is equipped with everything necessary for the patient's comfort before and after surgery.