logo

Call Us

+65 9838 5827
CONTACT US

Gallstones Treatment in Singapore

Dr Thng Yongxian

Gallstones Doctor
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS

BOOK AN APPOINTMENT

Gallstones are small, hard deposits that form in the gallbladder, a small organ located under the liver. They can vary in size and number, with two main types occurring: cholesterol stones and pigment stones.

 

In many cases, gallstones do not cause any symptoms and do not require treatment. However, if a gallstone blocks the flow of bile through the bile ducts, it can lead to inflammation or infection of the gallbladder or other serious conditions affecting the liver and pancreas.

Types of Gallstones

Cholesterol Gallstones

  • Composition: Predominantly made of hardened cholesterol, these stones account for around 80% of all gallstone cases. They also contain other substances found in bile.
  • Appearance: They are usually yellow-green and can vary in size and shape.
  • Formation: These stones form when bile contains too much cholesterol and not enough bile salts.

Pigment Gallstones

  • Composition: Composed mainly of bilirubin, pigment stones are formed from the breakdown products of red blood cells.
  • Appearance: These stones are smaller and darker, typically black or dark brown.
  • Formation: Conditions that cause increased red blood cell destruction, such as sickle cell anaemia, can lead to elevated bilirubin levels in bile, resulting in pigment gallstones.

Causes of Gallstones

The formation of gallstones is influenced by several factors, including:

Chemical Imbalance in Bile

The primary cause of gallstone formation is an imbalance in the chemical composition of bile, a digestive fluid produced by the liver. This imbalance can lead to the crystallisation of bile components, forming gallstones.

 

For cholesterol stones, the imbalance involves an excess of cholesterol in bile, while for pigment stones, it is an excess of bilirubin.

 

This imbalance can lead to the crystallisation of bile components, forming gallstones.

Gallbladder Function

The gallbladder’s main role is to store and concentrate bile. As such, if the gallbladder does not empty completely or regularly, the resulting concentrated bile may increase the risk of gallstone formation.

Other Risk Factors

  • Gender and Age: Women, especially those over 40 years old, have a higher risk of developing gallstones due to hormonal differences that may affect bile composition.
  • Obesity: Obesity can increase cholesterol in bile and reduce gallbladder movement, leading to gallstone formation.
  • Diet: A diet high in fat and cholesterol and low in fibre can increase the risk of gallstones.
  • Family History: A genetic predisposition to gallstones can be inherited, making family history a significant risk factor.

Signs and Symptoms of Gallstones

Asymptomatic Gallstones

Many individuals have gallstones without symptoms. These gallstones are often discovered incidentally during imaging tests for other conditions. As such, these people often do not require intervention from a gallstones doctor.

Symptomatic Gallstones

When symptoms do occur, they often include:

  • Sudden and intense pain in the upper right abdomen: Also known as biliary colic, this is one of the most common symptoms of gallstones. The pain can last from a few minutes to several hours, radiating to the back or right shoulder blade.

  • Nausea or vomiting: These symptoms often accompany the pain from biliary colic, indicative of digestive distress when a gallstone causes an obstruction.

  • Indigestion: This often presents as discomfort or a feeling of fullness after eating, particularly following meals high in fat.

  • Jaundice: If a gallstone blocks the bile duct, it can cause bile to build up in the liver. This can cause yellowing in the skin and eyes from jaundice.

Diagnosis of Gallstones

The diagnosis of gallstones involves a combination of clinical assessment, imaging studies, and laboratory tests:

Ultrasound

This is the primary imaging technique used to detect gallstones. It is non-invasive and highly effective at identifying stones within the gallbladder.

Computed Tomography Scan (CT Scan)

CT scans provide detailed images of the abdominal area, helping to diagnose complications or rule out other causes of abdominal pain.

Magnetic Resonance Cholangiopancreatography (MRCP)

MRCP is a specialised MRI technique that can visualise the biliary and pancreatic systems, providing valuable insights for diagnosing conditions like gallstones.

Endoscopic Ultrasound (EUS)

EUS combines endoscopy and ultrasound to provide detailed images of the digestive tract and surrounding organs, assisting a gallstones specialist in diagnosing gallstones or complications.

Blood Tests

Blood tests assess liver function and detect signs of inflammation or infection, which can provide crucial indicators for diagnosing gallstones.

Get an Accurate Diagnosis and Specialised Treatment for Gallstones

Consider consulting our dual fellowship-trained gallstones specialist to receive a precise diagnosis and explore gallstone treatment and surgery options in Singapore.

Make An Enquiry

Treating Gallstones

Watchful Waiting

  • This approach is often recommended for asymptomatic gallstones, involving monitoring without immediate intervention. This is because the risks of intervention may outweigh the benefits if symptoms are absent.

Medications

  • Ursodeoxycholic acid may be prescribed to dissolve small cholesterol gallstones, working by reducing cholesterol production and synthesis. 

    However, this option can take several months to years to work, with stones potentially recurring. It is crucial to consult a gallstones doctor to determine suitability, as side effects may occur.

Non-Surgical Procedures

  • Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure using an endoscope to access, break up, and remove gallstones lodged in the bile duct. While effective, potential risks include allergic reactions and inflammation to the pancreas.

Surgical Treatments

  • Laparoscopic Cholecystectomy: This is a surgical procedure where several small incisions are made in the abdomen to remove the gallbladder using a laparoscope and surgical instruments. The gallstones surgeon performs the operation while viewing a video monitor that displays the internal view of the abdomen. The procedure is minimally invasive, involving less postoperative pain and a shorter recovery time.

  • Open Cholecystectomy: This is a traditional surgery in which a larger incision is made in the abdomen to access and remove the gallbladder. It may be used in cases where the gallbladder is severely diseased, making removal more challenging, or if complications arise during a laparoscopic procedure.

Extracorporeal Shock Wave Lithotripsy (ESWL)

  • ESWL employs shock waves to break up gallstones, allowing for easier passage. However, it is not as commonly used due to limited effectiveness and high recurrence rates.

Complications Associated with Gallstones

In some cases, gallstones can lead to several complications:

  • Cholecystitis: This involves inflammation of the gallbladder, typically occurring when a gallstone blocks the cystic duct, leading to pain and potential infection. For acute cases, immediate medical attention by a gallbladder inflammation specialist is required.

  • Pancreatitis: If a gallstone blocks the pancreatic duct, the pancreas may get inflamed. Patients often experience severe abdominal pain and require urgent medical attention from a pancreatitis doctor.

  • Cholangitis: This is a serious infection of the bile ducts, usually resulting from gallstone obstruction, and can cause fever, jaundice, and abdominal discomfort.

  • Gallbladder Cancer: Although rare, a history of gallstones, particularly large ones, is considered a risk factor for this serious complication.

Dr Thng Yongxian

Senior Consultant

HEPATOPANCREATOBILIARY & GENERAL SURGEON

MBBS (SG) • MMed (Surg) • MRCS (Ire) • FRCSEd (Gen) • FAMS (Surg)

Dr Thng Yongxian is a dual fellowship-trained Hepatopancreatobiliary & General Surgeon who has performed over 6000 surgical procedures.

  • Bachelor of Medicine & Bachelor of Surgery
  • National University of Singapore
  • Membership of the Royal College of Surgeons, Ireland
  • Master of Medicine, General Surgery, Singapore
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Fellow of the Academy of Medicine, Singapore

He pursued his subspecialty training in Hepatopancreatobiliary surgery first in the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital. Following this, he completed a clinical fellowship in Minimally Invasive Hepatopancreatobiliary Surgery at Seoul National University Hospital in Bundang, South Korea.

 

Dr Thng set up and pioneered the Minimally Invasive surgery programme for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television, while his surgical videos have been presented at international surgical conferences. He also pioneered the use of capsule colonoscopy for colorectal screening.

 

Dr Thng has served on various committees at hospital, cluster and ministry level. For example, he was a member of the Ministry of Health (MOH) Laparoscopic Cholecystectomy Clinician workgroup for value-driven care (VDC).

Prevention and Management of Gallstones

Preventing the formation of gallstones may not always be possible, but some measures can reduce the risk.

  • Healthy Weight Management: As obesity and rapid weight loss are significant risk factors in the development of gallstones, maintaining a healthy weight can help prevent their formation.

  • Balanced Diet: Maintain a high-fibre and healthy fats diet while limiting intake of refined carbohydrates and unhealthy fats.

  • Regular Physical Activity: Aim for at least 150 minutes of moderate-intensity aerobic activity, such as brisk walking, each week. Alternatively, engage in 75 minutes of vigorous-intensity activity, like running.
  • Control of Blood Sugar Levels: For people with diabetes or insulin resistance, controlling blood sugar levels through diet, exercise, and medication can help reduce the risk of gallstones.

Frequently Asked Questions About Gallstones in Singapore

Can gallstones go away on their own?
Gallstones generally do not disappear on their own. While small gallstones may occasionally pass through the stool, larger stones are likely to remain. In this situation, a gallbladder removal surgery in Singapore may be needed to eliminate the gallstones.
The recovery time for gallbladder removal (cholecystectomy) varies. For laparoscopic cholecystectomy, patients often recover within two weeks. Meanwhile, an open cholecystectomy typically requires a longer recovery period of six to eight weeks.
Initially, a bland diet with minimal fats and fibre may be recommended as the digestive system adjusts after gallstone surgery. Consult your doctor on how to gradually return to a normal, healthy diet.
After gallbladder removal, gallstones generally cannot recur. However, if gallstones were present in the bile ducts or form there subsequently, further intervention by a gallstones surgeon may be necessary.

Related Liver Treatments

Corporate & Personal Insurance Plans

Clinic Locations

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Need help navigating your health?

If you’re experiencing symptoms or want to understand your treatment options, contact us today.