About Laparoscopic Gallbladder Surgery(Cholecystectomy)
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Laparoscopic surgery is unquestionably advantageous in terms of patient outcomes. But the procedure is quite complex from the surgeon’s perspective. This cutting-edge procedure offers total and fast recovery from certain complications such as gall bladder stones, hernia, appendix, diseases of the gastrointestinal tract and gynaecological disorder. Brij Laser and Laparoscopy Centre, runs under the supervision of a well known Laser and laparoscopic surgeon in Mumbai Dr.Brijendra Singh . It is truly the best place for surgery consultations.

Gallstones

What is the gallbladder?

The Gallbladder is a pear-shaped organ that sits beneath the liver in the right-upper abdomen. Its function is to store bile. It is attached to the bile ducts that come from the liver. These ducts carry bile from the liver to the gallbladder and intestine.It keeps the bile until the body needs it to digest fatty foods.

What are Gallbladder stones?

Gallstones are hardened deposits of excessive cholesterol in digestive fluid (bile) that can form in your gallbladder. Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time.

Types of gallstones

Types of gallstones that can form in the gallbladder include:

• Cholesterol gallstones: The most common type of gallstone, called a cholesterol gallstone, often appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, but may contain other components.

• Pigment gallstones: These dark brown or black stones form when your bile contains too much bilirubin

How gall bladder stones are formed?

Though there are several reasons to form Gallstones but they may result mainly due to the following causes

• When your bile contains too much cholesterol: Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones.

• When your bile contains too much bilirubin: Bilirubin is a chemical that's produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders. The excess bilirubin contributes to gallstone formation.

• When your gallbladder doesn't empty correctly: If your gallbladder doesn't empty completely or often enough, bile may become very concentrated, contributing to the formation of gallstones.

They can block the flow of bile out of the gallbladder into your digestive system. This roadblock causes cholecystitis (inflammation of the gallbladder).

When Gallbladder stones cause pain or other problems, removal of the gall bladder along with the stones, is the best treatment.The gallbladder is not necessary to maintain good health. In the past, open abdominal surgery was the standard treatment. This procedure required a 3 to 7 day stay in the hospital and a 3 to 7 inch incision and scar on the abdomen.

Risk factors

Who are at risk of producing gallbladder stones?

Factors that may increase risk of gallstones are as follows:

• Being female
• Being age 40 or older
• Being overweight or obese
• Being sedentary
• Being pregnant
• Eating a high-fat diet
• Eating a high-cholesterol diet
• Eating a low-fiber diet
• Having a family history of gallstones
• Having diabetes
• Having certain blood disorders, such as sickle cell anemia or leukemia
• Losing weight very quickly
• Taking medications that contain estrogen, such as oral contraceptives or hormone therapy drugs
• Having liver disease

Symptoms

What are the symptoms of Gallbladder stones?

Gallstones may cause no signs or symptoms. If a gallstone lodges in a duct and causes a blockage, the resulting signs and symptoms of cholecystitis (inflammation of the gallbladder) may include:

• Sudden and rapidly intensifying pain in the upper right portion of your abdomen
• Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone
• Back pain between your shoulder blades
• Pain in your right shoulder
• Nausea or vomiting
• Feeling bloated
• Fever with or without chills
• Jaundice (yellow-looking skin) is seen in advanced stage
• Gallstones can also move to other parts of the body and cause problems

Gallstone pain may last several minutes to a few hours.

Feel free to consult Dr. Brijendra Singh at Brij Laser and Laparoscopy Centre if you notice any of these symptoms.

Complications

What are the complications of gall bladder stones if not treated?

Complications of gallstones may include:

• Inflammation of the gallbladder: A gallstone that becomes lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever.

• Blockage of the common bile duct: Gallstones can block the tubes (ducts) through which bile flows from your gallbladder or liver to your small intestine. Severe pain, jaundice and bile duct infection can result.

• Blockage of the pancreatic duct: The pancreatic duct is a tube that runs from the pancreas and connects to the common bile duct just before entering the duodenum. Pancreatic juices, which aid in digestion, flow through the pancreatic duct. A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and usually requires hospitalization.

• Gallbladder cancer : People with a history of gallstones have an increased risk of gallbladder cancer. But likelihood of gallbladder cancer is very rare.

Diagnosis

How gallbladder stones are diagnosed?

Tests and procedures used to diagnose gallstones and complications of gallstones include:

• Abdominal ultrasound: This test is the one most commonly used to look for signs of gallstones.

• Endoscopic ultrasound (EUS): This procedure can help identify smaller stones that may be missed on an abdominal ultrasound. During EUS your doctor passes a thin, flexible tube (endoscope) through your mouth and through your digestive tract. A small ultrasound device (transducer) in the tube produces sound waves that create a precise image of surrounding tissue.

• Other imaging tests: Additional tests may include oral cholecystography, a hepatobiliary iminodiacetic acid (HIDA) scan, computerized tomography (CT), magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones discovered using ERCP can be removed during the procedure.

• Blood tests: Blood tests may reveal infection, jaundice, pancreatitis or other complications caused by gallstones.

Treatments

Treatment options for gallstones include:

1. Medical Treatment

Medications to dissolve gallstones: Medications you take by mouth may help dissolve gallstones. But it may take months or years of treatment to dissolve your gallstones in this way, and gallstones will likely form again if treatment is stopped. Sometimes medications don't work. Medications for gallstones aren't commonly used and are reserved for people who can't undergo surgery.

2. Surgical Treatment

Cholecystectomy (Surgery to remove the gallbladder)

(cholecystectomy): Your doctor may recommend surgery to remove your gallbladder, since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder. You don't need your gallbladder to live, and gallbladder removal doesn't affect your ability to digest food, but it can cause diarrhea, which is usually temporary.

Now the use of laparoscopy has been expanded to include removing a diseased gallbladder. With new video technology, the laparoscope has become a miniature television camera. Powerful magnification is now possible, showing the intestinal organs in great detail. Laparoscopic Surgeons make tiny incisions called port in the skin for the treatment. The patients are given anaesthesia beforehand to limit any pain or discomfort. It offers rapid recovery and minimal scarring.

A note from Brij Laser and Laparoscopy Centre