Gallstones

Frustrating little things! They reside in the gallbladder, and can vary in size from tiny crystals to golf balls. No wonder they can give a variety of symptoms!

About 10% of New Zealanders will have gallstones, but fortunately most of them will not cause any symptoms. About 4% of these patients will develop symptoms each year, and about half have their second set of symptoms within a year.

What are the symptoms of gallstones?

They may grumble a bit, with intermittent abdominal discomfort, which is nearly always in the upper abdomen. Often an episode of symptoms will wake you. Many people come to recognise that fatty or rich foods tend to set them off. Quite commonly the first inkling is an episode of upper abdominal pain that gets increasingly worse, and often radiates around or through, into the back. The unfortunate patient will have difficulty in getting comfortable, and may be belching, or start vomiting. The pain can get to be excruciating. Most of these attacks settle within several hours, and then the patient is completely clear until the next attack.

What should I do?

A severe attack will prompt you to seek medical attention for pain relief. If you are unable to reach your doctor, you can phone our office at any time … your call will be forwarded to the specialist on call.

Your doctor will usually arrange an ultrasound examination, which may prove the presence of gallstones. A blood test to check to see how things are functioning may be arranged. Once the diagnosis is confirmed, it is time to visit a laparoscopic surgeon for a chat.

How can gallstones be treated?

Gallstones are different than kidney stones, so they cannot be effectively smashed with sound waves. At the present time, they cannot be dissolved effectively. If it works you will spend about 2 years planning loo stops, as the side effects include marked diarrhoea. The stones will then reform after two years of treatment, as the problem actually lies within the gallbladder. Thus surgery is still the mainstay of treatment. The stones plus the gallbladder are removed, and there are no significant consequences of living without a gallbladder. Fortunately, this can now be achieved without the traditional large incision. The laparoscopic technique, or keyhole surgery, utilises 3-4 very small nicks to pass a camera and skinny instruments into the abdomen, and the surgeon operates from the outside of the abdomen. With small incisions, pain is minor and the cosmetic result is excellent.

How do I choose my surgeon?

You need to be completely happy with your surgeon. Your family doctor can advise you. An experienced surgeon can also save you money. The total fee is influenced by the time spent doing the operation. Thus saving 1 hour will lower the total fee by nearly $1000.

An experienced surgeon will also lessen the chance of having to convert to an operation. You can request the surgeon of your choice in the private sector. For those without private insurance, we can often arrange for patients to go home the same day, which substantially lowers the cost.

What is the recovery time after surgery?

Most people go home the following morning. We suggest that mothers of young children stay two nights to get a better rest…they deserve it!

For those with a sedentary job, one or two weeks off work will be in order. It is often influenced as to whether you are self-employed or not. Gym type activity is usually not enjoyed until about the third week or shortly thereafter. As far as driving is concerned, make sure you will be comfortable enough to be a safe driver, (usually about a week) and don't forget to check to see if your insurance has an exclusion clause for driving after surgery.

Any special diet afterwards?

No, not really. You're best to avoid rich fatty foods initially, as they may upset your tummy. There will probably be some foods that disagree with you forever, but these are generally foods that aren't good for you anyway. You won't miss them, as they won't appeal to you anymore.

Any more questions?

Feel free to contact us anytime. Our knowledgeable staff will be pleased to help.