The liver is a large, reddish-brown, organ located in the upper right portion of the abdominal cavity that secretes bile (a digestive enzyme) and is active in the formation of certain blood proteins and in the metabolism of carbohydrates, fats, and proteins.
The gallbladder is a sac which stores and concentrates bile. During a meal it contracts, secreting bile into the small intestine, via the cystic duct, where it aids in the digestion of fats. Bile contains bile salts, cholesterol and other compounds.
A Gallbladder polyp is a mass that can grow in the lining of the gall bladder. Most of these polyps are benign, however, once they reach a certain size, or if there are many polyps in the gallbladder, they become a risk for gall bladder cancer. Patients with gallbladder polyps should be evaluated for the need for cholecystectomy (removal of the gall bladder).
Cholelithiasis is the term used when bile becomes oversaturated with cholesterol or other compounds and gallstones begin to form. In most cases, gallstones do not cause symptoms. But in some patients, these stones may cause obstruction of the cystic duct, leading to inflammation and scarring. During the blockage, the patient might feel a severe pain on the right side, just under the ribs, called biliary colic. This cramping pain can continue steadily, with gradual relief occurring over a few hours. The blockage might also cause heartburn and indigestion.
Cholecystitis is an infection that occurs in the gallbladder because gallstones obstruct the flow of bile out of the gall bladder resulting in inflammation and infection of the organ.
Choledocholithiasis occurs when gallstones are emitted from the gall bladder but get trapped in the common bile duct. This can result in severe pain. It can also result in a back up of bile into the bloodstream that is known as jaundice.
Gallstone pancreatitis is an inflammation of the pancreas (another digestive organ) that occurs when gallstones irritate the pancreas as they are emitted from the gall bladder. Pancreatitis results in pain along the upper abdomen and back. It can be a mild or severe (and even deadly) disease.
Gallbladder removal, the cholecystectomy, is the most commonly performed minimally invasive procedure. It usually requires 4 small incisions to safely removal of the gallbladder. Most patients treated with cholecystectomy go home the same day of surgery. Pain from laparoscopic cholecystectomy is greatly reduced compared to traditional open surgery and return to regular activity is much sooner.
Your doctor might decide that a cholecystectomy is indicated to treat acute or chronic conditions of the gallbladder such as gallbladder polyps, biliary colic, cholecystitis, choledocholithiasis or gallstone pancreatitis.
Liver Cysts
Liver cysts, also called hepatic cysts, are fluid-filled sacs that occur in the liver of roughly 5% of the population. However, only about 5% of these patients ever develop symptoms. They are usually asymptomatic and often discovered by chance during an abdominal imaging procedure, like computed tomography (CT) or magnetic resonance imaging (MRI). Even though most liver cysts are benign, an early diagnosis is critical for proper treatment of the parasitic or cancerous subtypes. In most cases, treatment involves removal via minimally invasive surgical techniques.
Most cysts are single, although some patients may have several. The symptoms associated with liver cysts include upper abdominal fullness, discomfort, or pain. A small number of patients bleed into the cyst, which causes sudden and severe right upper quadrant and shoulder pain. The bleeding stops on its own and the pain then improve over the next several days. Liver cysts do not impair the liver’s ability to function.
Simple liver cysts are always benign. The only patients who require treatment for a liver cyst(s) are those who develop symptoms. Simply removing the fluid from the cyst with a needle is not effective because the cyst fills up again within several days. The best treatment is to remove a large portion of the cyst wall. This surgical procedure can usually be done laparoscopically, which requires only 2-3 small incisions and an overnight stay in the hospital. Most patients recover fully within 2 weeks. The risk of the cyst recurring is very low.
Unlike simple liver cysts, cystic tumors are actually growths that may become malignant over the course of many years. The benign cystic tumor seen most frequently is called a cystadenoma; its malignant counterpart is a cystadenocarcinoma. The symptoms caused by cystic tumors are the same as those seen with simple cysts; fullness, discomfort, and pain. The liver blood tests usually remain normal, unless a cancer has developed. US and CT scans are the best imaging studies to show the cystic tumors, which contain both liquid and solid areas. Because of the possibility of malignancy, cystic tumors must be completely removed surgically. The recurrence rate after surgery is very low and the long-term prognosis is excellent.
