Gallstones

Gallstones are solid pieces of material that form in the gallbladder, which is the sac located on the undersurface of the liver in the upper right-hand portion of the stomach cavity. The gallbladder aids in digestion by storing bile, which is produced and secreted continuously by the liver. After a meal, the gallbladder contracts and sends the stored bile into the intestine. When digestion of the meal is over, the gallbladder relaxes and continues to store bile.

About one million new cases of gallstones are diagnosed every year in the United States, and an estimated one in 10 people suffer from the condition, which is particularly common during the mid-life years. Women tend to develop gallstones more commonly than men and at a younger age.

Gallstones vary in size and volume, ranging from the size of a grain of sand to the size of a plum. The gallbladder may develop a single, often large stone or many smaller ones, even several thousand. Gallstones occur when the gallbladder crystallizes the components of bile it concentrates. Bile is a brown liquid containing bile salts, cholesterol, bilirubin and lecithin. Risk factors for developing gallstones include obesity, inherited body chemistry, body weight, sluggish gallbladder movement, hormones and possibly diet. For instance, very low calorie, rapid weight-loss diets and prolonged fasting, have been shown to cause gallstones. Some proteins in bile also can promote or inhibit gallstone development.

Our Approach to Gallstones

The most common treatment for gallstones is surgical removal of the gallbladder, known as cholecystectomy. UCSF gastrointestinal surgeons usually perform this as a minimally invasive laparoscopic procedure, inserting tiny instruments and a miniature camera through several small incisions.

UCSF surgeons helped pioneer laparoscopic gastrointestinal surgery, and they perform many of these procedures each year. Compared with traditional open surgery, minimally invasive surgery has significant benefits for patients, including a faster recovery, lower risk of infection, and less pain and scarring.

We also offer a nonsurgical procedure to remove gallstones from the bile duct, either during or after gallbladder removal. This option may also be used to relieve pain in patients who are too frail to undergo surgery.