All about Gallstones with top Leicester surgeon Mr Gavin Robertson

GallstonesHere, he answers the most commonly asked questions about gallstones and their management.

What causes gallstones?

Gallstones form in the gallbladder (a pear shaped reservoir on the side of the bile duct system) if the bile gets over concentrated, resulting in the formation of crystals that gradually grow into stones. being female, having children, getting older, having a family history and several other factors, all make this more likely to happen.

What are the common symptoms?

the commonest symptoms are bouts of severe pain in the right upper part of your abdomen often going through to your back. they can be mistaken for heart attacks and can last several hours, often in the evening or at night.

Can they cause even more severe problems?

yes. Infections in the gallbladder can cause the pain to persist and require hospital admission. If stones get pushed from the gallbladder into the bile duct system itself, they can cause blockages resulting in jaundice (yellow skin, dark urine and pale motions) or pancreatitis, a potentially deadly condition. In the longer term they have a 1 in 100 risk of causing gallbladder cancer.

How are they diagnosed?

a simple abdominal ultrasound scan like that used to monitor pregnancy is the best and usually the only investigation needed.

What is the best treatment?

Surgical removal of the gallbladder (cholecystectomy) is the only effective treatment and these days can be done with keyhole (laparoscopic) surgery over 99% of the time. Internet suggestions of trying to purge the stones by drinking litres of oil are bizarre and positively dangerous. the surgery involves a general anaesthetic (you’ll be asleep) and small 5-10mm cuts are made allowing keyhole surgery to remove the gallbladder and stones.

Are there any side effects?

If the surgery is straightforward it should just put you back to normal. there is a small risk of complications with any surgery but surgeons undertaking large numbers of laparoscopic gallbladder operations should have a risk of complications and conversion to more major surgery of close to zero. there are rarely any long-term problems.

How long does recovery take?

you are usually in hospital less than 24 hours. It normally takes a couple of weeks to be doing most things including work reasonably comfortably and perhaps another couple of weeks to feel fully fit.

What should I do if I know I have gallstones but have no problems from them?

If your surgeon is highly competent, the risks of surgery are considerably smaller than the risk of life threatening problems or cancer as a result of keeping your gallstones.

How do I know what to look for in a surgeon?

your surgeon should be doing over a hundred laparoscopic cholecystectomies a year, with a risk of conversion to more major surgery well below 1 in 100 and a chance of damage to the bile duct system during the surgery of less than 1 in 1000. your GP will usually be the best starting point for advice.

Where can I go locally for expert advice and how much does it cost?

If you have private health insurance or wish to pay for this procedure as a one-off, Nuffield Health Leicester Hospital on Scraptoft Lane has an established reputation for laparoscopic surgery with several Leicester based laparoscopic surgeons. a guide price for the total cost of the surgery is around £4000.

Gavin Robertson has been an NHS Consultant Surgeon at Leicester Royal Infirmary for over a decade building a reputation in laparoscopic surgery for gallstones and hernias operating on thousands of patients and has a private practice at Nuffield Health Leicester Hospital.