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The bile components that form gallstones include cholesterol, bile salts, and bilirubin. [2] Gallstones formed mainly from cholesterol are termed cholesterol stones, and those formed mainly from bilirubin are termed pigment stones. [2] [3] Gallstones may be suspected based on symptoms. [4] Diagnosis is then typically confirmed by ultrasound. [2]
A cholesterol crystal is a solid, crystalline form of cholesterol found in gallstones and atherosclerosis.Gallstones occurring in industrialized societies typically contain more than 70-90% cholesterol by weight, much of which is crystalline. [1]
Sometimes gallstones may get stuck in the cystic duct, which serves as a bridge between the gallbladder and the common bile duct, and can lead to inflammation in the wall of the gallbladder. [11] This inflammation of the gallbladder is known as cholecystitis and is a common indication for surgical removal of the gallbladder, or cholecystectomy ...
At this junction is a mucosal fold called Hartmann's pouch, where gallstones commonly get stuck. The muscular layer of the body is of smooth muscle tissue that helps the gallbladder contract, so that it can discharge its bile into the bile duct. The gallbladder needs to store bile in a natural, semi-liquid form at all times.
The most common cause of bile duct obstruction is when gallstone(s) are dislodged from the gallbladder into the cystic duct or common bile duct resulting in a blockage. A blockage of the gallbladder or cystic duct may cause cholecystitis. If the blockage is beyond the confluence of the pancreatic duct, this may cause gallstone pancreatitis.
[27] Removal of the gallbladder with surgery, known as a cholecystectomy, is the definitive surgical treatment for biliary colic. [28] A 2013 Cochrane review found tentative evidence to suggest that early gallbladder removal may be better than delayed removal. [29] Early laparoscopic cholecystectomy happens within 72 hours of diagnosis. [13]
Gallstones may result from increased saturation of cholesterol or bilirubin, or from bile stasis. Lower concentrations of bile acids or phospholipids in bile reduce cholesterol solubility and lead to microcrystal formation. Oral therapy with chenodeoxycholic acid and/or ursodeoxycholic acid has been used to dissolve cholesterol gallstones.
The gallbladder varies in size, shape, and position among different people. [2] Rarely, two or even three gallbladders may coexist, either as separate bladders draining into the cystic duct, or sharing a common branch that drains into the cystic duct. Additionally, the gallbladder may fail to form at all.