Bile fluid, which is produced in the liver and is necessary for digestion, is transmitted to the main bile ducts through small bile ducts in the liver and is poured into the intestine through the mouth opening into the duodenum. Some of the bile is transferred to the gallbladder, which is connected to the main bile duct with a duct
When plenty of bile is required for digestion,
hormonal and reflex mechanisms come into play, and with the contraction of the gallbladder,
a relatively large amount of bile is poured into the main bile duct and from there into the duodenum.
Bile is a fluid liquid. However, conditions such as long-term hunger, dehydration, infection, and high cholesterol may cause deterioration in the structure of the bile fluid, decrease in its fluidity, darkening, sludge and stone formation. Gallstones appear as bilirubin stones, cholesterol stones, or mixed stones containing both substances, depending on their bilirubin and cholesterol content. Cholesterol stones are the most common. It is thought to be formed by the decrease in the substances that keep the bile in a dissolved state or the increase in cholesterol. Bilirubin stones occur in diseases where blood destruction increases and It is more common in infections.
The incidence of stones increases with age and is more common in women. Gallbladder stones may occur with symptoms such as pain in the upper right part of the abdomen that radiates to the back, nausea, and bloating. In complications, symptoms such as fever and jaundice may be added to the table. Gallstones may be in the form of silent stones without any symptoms, or they may cause inflammation of the gallbladder (acute and chronic cholecystitis), gallbladder perforation, stones falling into the bile duct or obstructive jaundice caused by external pressure of the gallbladder on the bile ducts, pancreatitis and It can lead to emergency situations by causing inflammation (cholangitis) in the bile ducts. There is also a risk of developing gallbladder cancer due to stones. The first choice for diagnosis is ultrasonography. When necessary, methods such as MR/MRCP and ERCP are used. The treatment of gallstones that cause complaints and complications is
surgery. Nowadays, the gallbladder with stones is removed from the body using the laparoscopic cholecystectomy technique. Silent bile, that is, it does not cause any symptoms and is diagnosed incidentally Treatment of bladder stones is controversial. Patients should be thoroughly explained that the complications listed above may develop at a later date, may lead to fatal conditions such as pancreatitis, or even cause cancer, and the decision for follow-up or surgery should be made together with the patient. If the presence of bile duct stones is known before surgery, they should be treated first. For this purpose, bile duct stones are cleaned endoscopically with ERCP before the surgery, and then gallbladder surgery is performed laparoscopically. In recent years, with the laparoscopic common bile duct exploration technique, both the gallbladder and bile ducts can be cleaned during surgery. After the gallbladder and bile duct stones are cleared, efforts should be made to prevent the formation of new stones in the bile ducts by making the necessary dietary adjustments. However, in case of new stone formation, bile duct stones should be cleaned again with ERCP.
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