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Leaving no stone unturned!

07 February 2018

Unless you’ve had gallstones (or kidney stones or been through labour) it is almost impossible to appreciate just how painful this common condition can be. About 15% of the population has gallstones and removal of the gallbladder remains one of the most common surgeries performed today. They occur when chemical imbalances occur in bile, leading to the formation of crystals (stones) but in truth the exact balance between nature (genetics) and nurture (lifestyle risk factors) is poorly understood. Bile is produced by your liver to help digest food and some of this is stored in the gallbladder which acts as a bile reservoir. When you eat, the gallbladder contracts and pushes bile into the intestine to aid digestion. This explains why gallstones patients often experience pain during or shortly after meals. The pain may be felt in the upper abdomen, often on the right hand side and sometimes in the back or right shoulder. Occasionally nausea or indigestion symptoms are the principle complaint.

The presence of stones may be picked up incidentally, often by an abdominal ultrasound scan being performed for investigation of other conditions. Truly asymptomatic gallstones may be managed non-operatively although patients often appreciate a consultation to discuss the rationale and possible long-term complications.

Patients with symptomatic gallstones generally elect for surgery because of the severity of the pain and the fact that symptoms rarely resolve spontaneously. In addition there are the risks of inflammation (cholecystitis) or stones dropping out of the gallbladder and causing problems in adjacent organs (such as inflammation of the pancreas gland -pancreatitis). In this respect small stones can ironically be more troublesome than large ones. Although relatively rare, this can potentially be a very serious condition.

Gallbladder surgery performed by specialists is very safe and well tolerated. Most patients are suitable for keyhole surgery and can leave hospital on the same day as their procedure with recovery generally only one to two weeks. Patients are instantly cured of their gallbladder symptoms and once recovered there are no long term restrictions on activity or diet. In some ways the surgery may be liberating, as some patients who have avoided certain types of foods suddenly find they can eat whatever they wish without consequence. As with any surgery there are some small risks, such as conversion to open (non-keyhole) surgery in 1% of cases and damage to adjacent anatomical structures (one in 500 case), but your surgeon should go through these with you.

Despite targets, NHS waiting lists can still be long. To meet the high demand, Spire Clare Park offers self-pay options with surgery being available in a matter of weeks.

Appointments can be made with Mr. Davies by contacting his practice secretary 0203 763 5933 or Clare Park directly on 01252 895490.

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