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The gall bladder or cholecyst is a small gland which sits on the bile duct between the liver and the intestines. It stores bile, which is more or less an organic detergent produced by the liver that helps digest fat. The gall bladder concentrates the bile as it is produced by the liver and releases it as required to digest fat. Not all mammals have a gall bladder, with the likelihood of a mammal having one being related to how much meat and fat are in their diet. For example, rats and horses do not have gall bladders.
Most people have no problems with their gall bladders, but for unknown reasons either fats or salts will precipitate out of the bile in certain patients, leading to the formation of gallstones. If a gallstone becomes lodged in the bile duct, it leads to cholecystitis, a painful condition that often feels like severe heartburn which can last for hours or days until the stone passes into the intestine. However, if the stone remains lodged, patients will often develop acute cholycystitis, characterized by fever and fatigue caused by bacterial infection in the gall bladder. If this condition is not treated promptly, it may be life threatening. However, most stones pass normally into the intestine.
Cholycystitis is usually associated with one of four risk factors - middle age, obesity, a history of intestinal gas, and being female (hence the handy alliteration for medical students - FORTY, FAT, FLATULENT and FEMALE).
Frequent cholycystitis is usually treated by removing the gall bladder - a Cholecystectomy. This operation was impossible before the advent of anesthesia as a surgeon could not remove the gall bladder before the patient bled to death and died from shock. Historically, the operation required a large open incision and about four weeks of recovery. However, the operation can now be performed with laparoscopic instruments, and recovery time is usually less than two weeks, with the patient being released from hospital on the day of surgery.