By President Samuel Kwok, Rotary Club of HK Northwest

Gall stone is a common phenomenon that affects human of all races, both genders and commonly in adult life. It is the result of condensation and deposition of pigmented material inside the gall bladder which is a bag-shaped organ under the liver having the function of storing and ejecting bile into the small bowel for digestion of fatty food when necessary.

Gall stones give rise to the symptom of abdominal pain, usually in the upper abdomen like that of gastric discomfort, especially after meal. When some of the stones blocks the exit of the gall bladder, it can give rise to inflammation of the gall bladder known as acute cholecystitis, the pain can then be very severe, the right upper part of the abdomen would be tender to touch and there may also be fever.

However, if the stones are much smaller, they can migrate down and block the main bile duct giving rise to jaundice (the yellowing of the eyes and skin), abdominal pain and swinging fever, a condition known as acute cholangiits. This is an even more urgent condition requiring endoscopic or surgical treatment.

Another serious complication that can occur as a result of gall stones is acute pancreatitis, which is inflammation of the pancreas and this condition is potentially fatal.

Knowing all these possible complications from gall stones disease, the best treatment in this modern day medicine is still surgical removal of the gall bladder together with all the gall stones. Cracking the stones by external means and let the stones drain down the bile duct should not be done and it can easily give rise to blockage of bile duct, a condition that we should avoid by all means. Surgical removal of gall bladder in this day and age is essentially laparoscopic cholecystectomy. This is a kind of key-hole surgery in which the gall bladder is separated from the liver.  The cystic duct (connection to the common bile duct) and the cystic artery are divided and clipped. The gall bladder carrying all the stones inside is then taken out of the body via the small key-hole at the belly button. Patients after this kind of laparoscopic surgery can usually leave hospital in one to two days time. The digestive function usually returns to normal after cholecystectomy.

When the gall stone becomes symptomatic, laparoscopic cholecystectomy is the most effective and least harmful treatment method of gall stone disease. It is better to remove the gall bladder and its stones at an convenient time then to take the risk of allowing all those serious complications to occur.