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Gallstones are stones that form in the gallbladder and there are two main types: cholesterol stones and pigment stones.

Cholesterol stones are the most common type, accounting for over 90% of cases in Singapore. These stones develop when there is an excess of cholesterol in the bile, leading to the formation of cholesterol salts that eventually crystallise and create stones. Having high blood cholesterol levels does not necessarily increase the risk of developing gallstones. Both individuals with and without high cholesterol levels are equally likely to develop cholesterol stones, which typically occur in people over the age of 30.

Pigment stones are a less common type of gallstone and are caused by high levels of bilirubin in the bile. This happens due to the breakdown of red blood cells and is commonly seen in people with red blood cell disorders such as thalassemia, sickle cell anemia, and hereditary spherocytosis. Pigment stones tend to occur in younger people, typically in their 20s to early 30s.

The majority of people with gallstones do not experience any symptoms, and the condition is usually discovered during diagnostic imaging for other unrelated issues. However, those who do experience symptoms often report a range of discomforts that occur after eating, including mild discomfort, bloating, or severe pain. These symptoms typically occur in the upper central or right upper quadrant of the abdomen.

Some individuals with non-symptomatic gallstones will go on to develop pain or complications in their lifetime. This occurs at a greater percentage in the first five years after the discovery of the gallstones.

Cholecystectomy, or gallbladder removal surgery, is mostly done using laparoscopic techniques, which involve making small incisions in the abdomen. This method has several advantages, including smaller wounds, less stress on the body, shorter hospital stays, less post-operative pain, and lower wound infection rates. During the procedure, four small incisions are made, with the largest one at the belly button and the others ranging from 5-8mm in length. The entire gallbladder, along with any gallstones, is removed through these incisions. The cystic duct, which connects the gallbladder to the common bile duct, is closed off with surgical clips, and the gallbladder does not regrow after the surgery.