Laparoscopic Gallbladder Stone Surgery Program

Laparoscopic Gallbladder Stone Surgery Program

Bangkok Hospital Phitsanulok

Over the past 10 years (2014–2023), Bangkok Hospital Phitsanulok has performed a total of 379 laparoscopic gallbladder surgeries. The number of surgeries performed each year is as follows:

 

Types of Gallstones

• Cholesterol Stones Accounting for approximately 80% of all gallstones, these stones are typically white, yellow, or green in color. They form when cholesterol levels in bile increase or when the gallbladder does not contract effectively, preventing complete expulsion of bile.
• Pigment Stones Smaller and darker in color than cholesterol stones, pigment stones are more commonly found in individuals with liver cirrhosis or blood disorders such as thalassemia or G6PD deficiency.

Risk Factors for Gallstones

Gallstones often develop without symptoms and are usually discovered during routine health check-ups or investigations for other health issues. However, certain factors can increase the likelihood of developing gallstones, including:

• Genetics: Family history significantly increases the risk.

• Obesity: Increases cholesterol content in bile.

• Estrogen and Pregnancy: Raise cholesterol levels and slow gallbladder movement. Women using birth control pills or hormone replacement therapy are more at risk.

• Gender and Age: More common in women and older adults.

• Diabetes: High triglyceride levels and poor gallbladder motility in diabetics raise the risk.

• Rapid Weight Loss: Stimulates the liver to secrete more cholesterol while reducing gallbladder contractions, increasing bile stasis and stone formation.

• Diet: High-fat, low-fiber diets contribute significantly to gallstone development.

Symptoms of Gallstones

Although many patients are asymptomatic, when symptoms do occur, they may include:

• Severe abdominal pain, especially in the upper right abdomen, lasting from 15 minutes to several hours. Pain may radiate to the right shoulder or back.

• Nausea and vomiting.

• Bloating, indigestion, and excessive gas.

• A burning sensation in the chest or upper abdomen, especially after consuming fatty foods.

• In cases of acute cholecystitis: fever, pain under the right rib cage, jaundice, and dark-colored urine may occur.

Treatment Options for Gallstones

• Gallbladder Removal Surgery

• Open Cholecystectomy

• Laparoscopic Cholecystectomy

• Endoscopic Retrograde Cholangiopancreatography (ERCP) – Used when gallstones are present in the bile ducts.

Potential Side Effects of Gallbladder Removal

The gallbladder’s primary role is to store bile. After removal, bile continues to be produced by the liver and flows directly into the small intestine. While most patients digest fats normally, about 10% may experience mild diarrhea due to continuous bile flow.
 
Note:
Laparoscopic gallbladder surgery should be performed by experienced surgeons to minimize complications such as bile duct injury, leakage, or blockage.