Just as saliva naturally forms in the mouth when we see food, consuming oily foods triggers the production of digestive fluids in the body. These fluids include cholecystokinin pancreozymin, which are released when the gall bladder contracts. The cholecystokinin hormone plays a key role in gall bladder contraction, allowing the fluid to flow through the ducts. Sometimes, however, a stone can become lodged in these ducts, leading to pain. This pain is a distinctive and classic symptom, especially after consuming oily foods.
If we divide the stomach into four regions using a horizontal and vertical line through the navel, the upper right quadrant is where you’ll experience pain if the gall bladder is affected. When a stone is present in the gall bladder, the common question arises: can’t the stone be removed? Why is the gall bladder removed instead?
The reason lies in the fragile nature of the gall bladder’s wall, which is thinner than a sheet of paper. Removing a stone and then suturing such a delicate wall could result in fluid leakage, which can be life-threatening. This is not a new idea; doctors have known about it for a century. Extensive research has shown that opening the gall bladder is a risky procedure.
By removing the gall bladder entirely, the risk of future stones is eliminated. It’s considered a complete cure. Ignoring gall bladder stones is acceptable as long as they remain in the gall bladder, but if a stone moves into the cystic duct, it can cause pain. This duct connects to the common bile duct, which carries digestive fluids from the liver to the intestines for the digestion of fatty foods. A blockage in this main vessel can lead to jaundice.
When stones become stuck and cause jaundice, two surgeries may be required. The first is a laparoscopic procedure to remove the gall bladder, and the second is an endoscopic retrograde cholangiopancreatography (ERCP) to address the stone causing the blockage. ERCP involves passing instruments through the mouth and cannot be performed through a small incision near the navel. Thus, two surgeries may be necessary in such cases.
In conclusion, remember this golden rule: no pain, no surgery. Regardless of the stone’s size, if it isn’t causing pain, there’s no need for surgery. However, when pain is present, it’s advisable to undergo surgery to address the issue promptly.