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Inflammation of the Gallbladder

Dr Thng Yongxian

Hepatopancreatobiliary & General Surgeon
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS

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What Is Gallbladder Inflammation?

The gallbladder is a small, pear-shaped organ located beneath the liver. Its primary function is to store and concentrate bile, a digestive fluid produced by the liver.

 

Gallbladder inflammation, medically known as cholecystitis, occurs when this organ becomes irritated or infected. This condition can be acute, which occurs suddenly and requires immediate medical attention, or chronic, which develops slowly over time.

 

If left untreated, this inflammation can lead to severe complications, including a ruptured gallbladder.

Causes

Gallbladder inflammation arises from various underlying conditions, such as:

  • Gallstones: Gallstones are the primary cause of gallbladder inflammation. These crystalline formations can obstruct the cystic duct, leading to bile buildup that may result in inflammation or infection.
  • Tumours: Tumours in the gallbladder or bile ducts can impede the normal flow of bile, causing bile accumulation and subsequent inflammation.
  • Biliary Sludge: Biliary sludge, a mixture of bile particles and cholesterol crystals, can also obstruct bile flow, similar to gallstones and lead to inflammation.
  • Infections: Bacterial or viral infections can directly infect the gallbladder, especially in individuals with weakened immune systems, leading to inflammation.

Symptoms

Recognising the symptoms of gallbladder inflammation is critical for timely diagnosis and treatment. Symptoms can vary in intensity and duration, depending on whether the condition is acute or chronic

Acute Symptoms

  • Severe pain in the upper right abdomen, which may extend to the back or right shoulder blade
  • Fever and chills
  • Nausea and vomiting
  • Tenderness in the abdomen, particularly on the right side

Chronic Symptoms

  • Recurrent mild abdominal pain, especially after eating fatty foods
  • Bloating and indigestion symptoms
  • Jaundice, a condition marked by yellowing of the skin and eyes

Diagnosis

Medical History and Physical Examination

The diagnostic process begins with a comprehensive review of the patient’s medical history and a physical examination, where the doctor may check for abdominal tenderness.

Blood Tests

Blood tests are conducted to check for signs of infection or inflammation in the body. Elevated white blood cell count, liver enzymes, and bilirubin levels can suggest gallbladder inflammation.

Imaging Tests

Imaging tests can help in diagnosing gallbladder inflammation and identifying its causes:

  • Ultrasound: The most common and effective imaging test for detecting gallstones and other abnormalities in the gallbladder.
  • Hepatobiliary iminodiacetic acid (HIDA) scan: This nuclear imaging test assesses the functioning of the gallbladder and bile ducts.
  • Computed Tomography (CT) scan: CT scans obtain detailed images of the gallbladder and surrounding structures, identifying inflammation or other complications.
  • Magnetic Resonance Imaging (MRI): MRI scans can provide detailed images of the bile ducts and gallbladder, useful in diagnosing blockages or other abnormalities.

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Treatment Options

The management of gallbladder inflammation varies depending on its severity, whether it is acute or chronic, and the underlying causes, such as gallstones or infection. Treatment strategies range from non-surgical to surgical interventions.

Non-Surgical Treatment Options

Conservative methods include:

Fasting

Helps rest the gallbladder, reducing the demand for bile production.

Pain Management

Analgesics are prescribed to alleviate abdominal pain.

Antibiotics

These are used to treat or prevent infections, particularly if bacteria have caused the inflammation.

The above methods are mainly for symptom relief and do not treat the source of infection, which often leads to a recurrence of symptoms.

Surgical Treatment Options

Surgical intervention is commonly recommended for treating acute conditions or chronic conditions with symptoms:

  • Laparoscopic Cholecystectomy: The preferred method for gallbladder removal, this minimally invasive surgery involves several small incisions to remove the gallbladder, offering shorter recovery times.
  • Open Cholecystectomy: A more invasive approach requiring a larger abdominal incision, which is necessary if laparoscopic surgery is not feasible.

Preventing Gallbladder Inflammation

While not all cases of gallbladder inflammation can be prevented, there are several strategies to reduce the risk of developing the condition.

  • Healthy Diet: Consuming a diet rich in fruits, vegetables, whole grains, and lean proteins can help maintain a healthy weight and reduce the risk of gallstones. Drinking plenty of water throughout the day also helps to maintain bile fluidity, potentially reducing the risk of gallstone formation.
  • Weight Management: Avoid rapid weight loss, as this can increase the risk of gallstones. Obesity is also a significant risk factor for gallstones and gallbladder disease, making weight management very important.
  • Physical Activity: Engaging in regular physical activity can help maintain a healthy weight and reduce the risk of gallstones.
  • Regular Health Check-Ups: Regular visits to a hepatopancreatobiliary specialist can help detect risk factors or early signs of gallbladder issues, allowing for early intervention.

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 program for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television. His surgical videos have also 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. Dr Thng served as a member of the Ministry of Health (MOH) Laparoscopic cholecystectomy Clinician workgroup for value-driven care (VDC).

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Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

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