Does gallstone cause gallbladder cancer?

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1. Causes of Gallstones
2. Risk Factors for Gallstones
3. Risk factors associated with Gallbladder Cancer
4. Gallstone Size and Risk of Gallbladder Cancer
5. Surgery of Gallbladder

After receiving a diagnosis of gallstones, one of the most important questions that patients have is if they might develop gallbladder cancer. Gallstones are a risk factor for gallbladder cancer. Four of the five people who have gallbladder cancer also have gallstones. However, gallbladder cancer is only found in around 1% of people who have gallstones.

A single huge stone is more likely to cause cancer than multiple smaller ones. Large gallstones are thought to form over a protracted time, causing irritation to the gallbladder wall and elevating the likelihood of developing cancer.

The causes of gallstones are as follows:

• Cholesterol build-up in bile: 
  The molecules in your bile dissolve the cholesterol. However, if there is a surplus of cholesterol, it may crystallize into stones known as cholesterol gallstones.
• Too much bilirubin: 
  The breakdown of RBCs by your body produces bilirubin. However, excessive bilirubin production contributes to the development of pigmented gallstones.
  
• Excessive bile: 
  Bile may concentrate in your gallbladder and clump together to produce gallstones if the organ doesn’t drain completely.

Risk factors for gallstones

With age, there is a higher likelihood of gallbladder stones forming. Gallstones are more likely to develop in those over the age of 40. The following are some elements that raise the risk of gallstone disease:

• Family history of gallstone formation
• Being fat or overweight
• Afflicted with diabetes
• Having a high blood pressure condition
• Alcohol consumption
• Smoking
• Young women
• Women who have multiple pregnancies
• Continuous usage of birth control tablets

Following are a few risk factors associated with gallbladder cancer.

• Gallstones
• Porcelain gallbladder
• Being a woman
• Increased age
• Carcinogens
• Obesity
• Gallbladder polyps
• Choledochal cyst
• Primary sclerosing cholangitis
• Chronic typhoid and paratyphoid infection

Gallstone Size and Risk of Gallbladder Cancer

A medical investigation found a significant link between the size of gallstones and gallbladder cancer. Gallbladder cancer is more likely to develop in older adults with big gallstones (equal to or larger than 3 cm). A study showed that the risk of gall bladder cancer more than doubled when the size of stone was 2cm or more. And the risk was more than 10 fold in stones that were 3cm or more. Gallstones are thus a key risk factor of gallbladder cancer.

Surgery of Gallbladder

Surgery to remove the gallbladder is a routine treatment. For the vast majority of patients, digestion is unaffected by the procedure. Typically, doctors advise the operation when gallbladder stones start causing symptoms. Cholecystectomy is the medical word for the removal of the gallbladder by surgery.

When the stones are not causing any symptoms, surgery is advised if the size of the stone is 2cm or more, due to increased risk of gall bladder cancer. 

For stones smaller than 2cm without symptoms, the decision of surgery is taken in the following situations – liver disorders, diabetes, children, sickle cell anaemia, spinal cord injuries, transplant candidates, and nonfunctional or porcelain gall bladder. 

A cholecystectomy may be of 2 different types:

• Laparoscopic cholecystectomy :

An enhanced method of removing the gallbladder is laparoscopic cholecystectomy. The surgeon makes small incisions on the belly during this minimally invasive procedure. The surgical instruments and camera  needed to remove the gallbladder are inserted via these small  incisions. Because just a few small incisions are needed, the patient recovers with minimal discomfort and difficulties. Additionally, the healing process is quick and easy. Laparoscopic cholecystectomy is now the gold standard for gall bladder stones.

• Open Cholecystectomy :

In open cholecystectomy, the liver and gallbladder are made visible by a sizable incision on the abdomen. With the advent of laparoscopic surgery, the need for open surgery has reduced dramatically. Compared to laparoscopic surgery, open surgery carries a higher chance of bleeding, post-operative pain and a relatively longer recovery time. 

Conclusion

Different kinds and sizes of gallstones are possible. Large stones raise the risk of gallbladder cancer.  Surgical removal of the gallbladder provides an easy remedy to reduce this risk.