Gallbladder Stones — UPMC Salvator Mundi International Hospital

UPMC's service for the diagnosis and treatment of gallstones and biliary tract stones, i.e., gallstones, offers a variety of specialized solutions. For the treatment of different forms of biliary lithiasis and its complications, including acute cholecystitis, choledochal lithiasis, cholangitis, and acute pancreatitis.

Our multidisciplinary team of surgeons, radiologists, anesthesiologists, gastroenterologists, nutritionists, and physical therapists will provide you with comprehensive treatments, including the post-operative recovery phases.

What Are Gallbladder Stones?

Gallstones are the presence of stones (cholelithiasis) within the gallbladder. In Italy, this condition affects about 20% of the adult population, with a higher prevalence in

females and in older age groups.

In some cases, stones can affect the entire biliary tree, that is, the system that carries bile from the liver to the intestine.

Symptoms

Often, in the early stages of cholelithiasis, patients have no symptoms. Later, however, they may begin to suffer from:

• Epigastric pain.
• Biliary colic.
• Dyspeptic syndrome, i.e., intolerance to fatty and fried foods, feeling of heaviness.
• Biliary sludge or bile sand.

Diagnosis

Diagnosis of cholelithiasis can be made starting from the results of specific exams, including:

• Liver ultrasound – to detect the presence of stones and assess the state of health of the walls of the gallbladder and the surrounding liver parenchyma.
• Cholangio MRI – in case there is suspicion of biliary tract lithiasis.

Treatment

Treatment of gallbladder stones is surgical: it is performed by minimally invasive laparoscopic cholecystectomy surgery. Post-surgical recovery is extremely rapid and, at UPMC Salvator Mundi International Hospital, it is followed and monitored after surgery.

You will have at your disposal our integrated Physiotherapy and Rehabilitation services. Here, you will also find professionals who are experienced in the specific recovery phases of athletes.

Pathologies treated

Every year, people with cholelithiasis experience complications in about 8% of cases. In 1-3% of cases, the diagnosis is due to the symptoms of a complication. Among these, the most common are:

• Acute cholecystitis: Its symptoms are: biliary colic, fever, and jaundice, discolored urine, and pale stools. If not properly treated, it can cause pus accumulation in the gallbladder and leakage of fluid if the wall is perforated, and septic shock. Generally, in this case, the recommended treatment is surgical.
• Choledochal calculi: This occurs in the common end tract of the biliary tract. Its symptoms are intermittent pain, with possible nausea, and, in some cases, infection and fever. It can become further complicated by acute pancreatitis. In this case, treatment can be endoscopic and surgical.
• Cholangitis (acute or ascending): This is an infection of the bile ducts usually caused by bacteria, and often coincides with partial obstruction of the bile duct due to gallstones. Its symptoms are intermittent fever, abdominal pain and jaundice, dark urine, and pale stools. Initially, the recommended treatment is via antibiotics. Later, surgical treatment may be needed, whether this is traditional, laparoscopic, or performed endoscopically.
• Acute pancreatitis: This is the most serious complication of gallbladder stones. It is caused by the presence of a stone in the main biliary tract that obstructs bile flow in the intestine. Its symptoms are intense and continuous abdominal pain, that does not decrease with analgesics. These symptoms may be associated with vomiting; paralytic ileus; hypotension, fever, hyperamylasemia; leukocytosis; and hyperglycemia. Cases of acute pancreatitis in which urgent surgical intervention is necessary are rare. If gallstones are causing the condition, treatment involves cholecystectomy (removal of the gallbladder), usually performed laparoscopically.
• Gallbladder cancer: This is not a complication of cholelithiasis but it is associated with it. The continued presence of stones in the gallbladder, in fact, can cause prolonged irritation of the gallbladder wall and this can lead to the development of tumors. The main symptoms of gallbladder cancer are: progressive jaundice with continuous pain and palpable swelling in the right hypochondrium, associated with anorexia, weight loss, and asthenia.