ANATOMY

The gallbladder is a small pouch that sits just under the liver. The gallbladder stores bile produced by the liver. After meals, the gallbladder is empty and flat, like a deflated balloon. Before a meal, the gallbladder may be full of bile and about the size of a small pear. In response to signals, the gallbladder squeezes stored bile into the small intestine through a series of tubes called ducts. Bile helps digest fats, but the gallbladder itself is not essential. Removing the gallbladder in an otherwise healthy individual typically causes no observable problems with health or digestion yet there may be a small risk of diarrhea and fat malabsorption.

PATHOPHYSIOLOGY Cholecystitis is inflammation of the gallbladder, usually resulting from a gallstone blocking the cystic duct. Chronic cholecystitis is gallbladder inflammation that has lasted a long time. It almost always results from gallstones. It is characterized by repeated attacks of pain (biliary colic). In chronic cholecystitis, the gallbladder is damaged by repeated attacks of acute inflammation, usually due to gallstones, and may become thick-walled, scarred, and small. The gallbladder usually contains sludge (microscopic particles of materials similar to those in gallstones), or gallstones that either block its opening into the cystic duct or reside in the cystic duct itself

Precipitating Factors: Predisposing Factors: 35yrs. Old Filipino Male

Female sex Obesity or rapid weight loss Drugs (especially hormonal therapy in women) Pregnancy Increasing age

Obstruction of the cystic duct Leading to distension of the gallbladder Blood flow and lymphatic drainage are compromised Leading to mucosal ischemia Necrosis

PROCEDURE

Cholecystectomy is the surgical removal of the gallbladder. It is the most common method for treating symptomatic gallstones. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy. A traditional open cholecystectomy is a major abdominal surgery in which the surgeon removes the gallbladder through a 10-18 inch (26 -45 cm) incision. Patients usually remain in the hospital overnight and may require several additional weeks to recover at home.