Below is a narrated animation about gallstones and surgical treatment. Click here to license this video and/or other digestive system videos on Alila Medical Media website.

Bile production and storage

The gallbladder is a small sac located underneath the liver. The gallbladder serves to store and concentrate bile. Bile is a yellowish-green fluid secreted by the liver and contains bile acids which aid in fat digestion and absorption. Bile flows through the bile duct into the duodenum – the first part of the small intestine. After filling the bile duct, it overflows into the gallbladder where it is stored for later use. After a high-fat meal, the gallbladder contracts to pump bile into the duodenum.

Fig. 1: Anatomy of the liver, gallbladder, pancreas, duodenum and the biliary tree. Click on image to see it on Alila Medical Media website where the image is also available for licensing (together with other related images and videos).

Gallstones and Complications

Gallstones are hard masses formed in the gallbladder. Gallstones may cause obstruction of the cystic duct and excruciating pain when the gallbladder contracts. This usually happens after a fatty meal and is commonly referred to as gallbladder attack. Blockage of the cystic duct is a common complication caused by gallstones.

Fig. 2: Gallstones block cystic duct. Click on image to see it on Alila Medical Media website where the image is also available for licensing (together with other related images and videos).

 

 

 

 

Other less common but more serious problems occur when gallstones become lodged down the path of the biliary tree. When gallstones block the common bile duct, they prevent bile from reaching the intestine. This causes jaundice, poor fat digestion and subsequently leads to infection of the bile duct or cholangitis. Gallstones may also obstruct the pancreatic duct, forcing pancreatic enzymes to back up in the pancreas. This damages the pancreatic tissue and triggers inflammatory response. This condition is known as acute pancreatitis or sudden inflammation of the pancreas.

Fig. 3: Acute pancreatitis caused by gallstones. Click on image to see it on Alila Medical Media website where the image is also available for licensing (together with other related images and videos).

Surgical treatment

The most common treatment for gallstones is the surgical removal of the gallbladder or cholecystectomy. Laparoscopic cholecystectomy is currently the standard procedure for gallbladder removal. This minimally invasive procedure requires only several small incisions in the abdomen and thus results in less pain and quicker recovery. The cystic duct and cystic artery are clipped with tiny titanium clips and cut. The gallbladder is then dissected and removed through one of the incision.

Fig. 4: Gallbladder removal surgery.  Click on image to see it on Alila Medical Media website where the image is also available for licensing (together with other related images and videos).

 

 
After surgery, bile enters the intestine without being concentrated in the gallbladder and may not be sufficient after a high-fat meal. A low-fat diet is therefore recommended after removal of gallbladder.