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Surgery To Remove Gall Stones

Open Surgery To Remove The Gallbladder

Gallstones and Surgical Removal of Gallbladder (Cholecystectomy) Animation.

You may have to have open surgery if keyhole surgery isn’t possible. You might also need open surgery if an unexpected complication happens.

Keyhole surgery may not always be recommended.

You doctor may tell you not to have keyhole surgery if you:

  • are in the last 3 months of pregnancy
  • are extremely overweight
  • have an unusual gallbladder or bile duct structure that makes keyhole surgery difficult

If this is the case, you may have open surgery to remove the gallbladder. The medical name for this is an open cholecystectomy.

Gallstone Disease Treatment: Extracorporeal Shock Wave Lithotripsy

Extracorporeal shock wave lithotripsy is a nonsurgical alternative to manage gallstones. You can receive this treatment as long as your gallbladder is functioning normally and your stones are small.

You do not need anesthesia for ESWL, and the procedure may be performed as an outpatient. This method uses high-energy sound waves to produce shock waves. The shock waves are strong enough to fracture and disintegrate the gallstones.

Patients who cannot undergo surgery may be good candidates for ESWL.

Gallstones And Bile Duct Stones

The function of the gallbladder is to store bile that is secreted by the liver. Following a meal, this stored bile is released into the intestine, aiding digestion. Abnormalities of bile composition can lead to the formation of gallstones. Anyone can develop gallstones, but known risk factors include being female, obese and older than 60. In most patients with gallstones, the stones are confined to the gallbladder but sometimes they appear in and block the common bile duct, the tube that transports bile from the gallbladder to the intestine. Learn more about gallstones, their risks and causes.

At Brigham and Womens Hospital , our board certified general and gastrointestinal surgeons offer the most innovative and effective treatment for patients with bile duct stones and gallstones, performing the latest and most effective minimally invasive surgical procedures, including laparoscopic cholecystectomy.

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When Is Gallbladder Removal Surgery Necessary

If your gallstones do not cause any symptoms, then thereâs no need to treat them. However, if you do experience symptoms, you may need to have your gallbladder removed. Some of the symptoms you may experience when you have gallstones include:

  • Sudden pain in the upper right side of your abdomen or in the center of your abdomen, directly below your breastbone that rapidly intensifies
  • Back pain located directly between your shoulder blades
  • Pain in your right shoulder

Doctors donât typically rush to remove your gallbladder. Theyâll wait to see if you have more than one attack. However, surgery is the best way to prevent future attacks. If you do need surgery and youâre located near San Francisco, California, BASS Medical Group can help. Their elite team is made up of doctors who are experts in their respective fields. Call 350-4044 to learn more or schedule an appointment.

What Are The Symptoms And Complications Of Gallstones

Laparoscopic Gallbladder Surgery for Gallstones in El Paso

Many people with gallstones do not have symptoms. Gallstones that do not cause symptoms are called asymptomatic, or silent, gallstones. Silent gallstones do not interfere with the function of the gallbladder, liver, or pancreas.

If gallstones block the bile ducts, pressure increases in the gallbladder, causing a gallbladder attack. The pain usually lasts from 1 to several hours.1 Gallbladder attacks often follow heavy meals, and they usually occur in the evening or during the night.

Gallbladder attacks usually stop when gallstones move and no longer block the bile ducts. However, if any of the bile ducts remain blocked for more than a few hours, complications can occur. Complications include inflammation, or swelling, of the gallbladder and severe damage or infection of the gallbladder, bile ducts, or liver.

A gallstone that becomes lodged in the common bile duct near the duodenum and blocks the pancreatic duct can cause gallstone pancreatitisinflammation of the pancreas.

Left untreated, blockages of the bile ducts or pancreatic duct can be fatal.

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Causes And Risk Factors For Gallstones

Gallstones are more common in women than in men. They are also more common in overweight people and people with a family history of gallstones.There is no single cause of gallstones. In some people, the liver produces too much cholesterol. This can result in the formation of cholesterol crystals in bile that grow into stones. In other people, gallstones form because of changes in other components of bile or because the gallbladder does not empty normally.

Who Needs Gallbladder Removal Surgery

Your doctor may recommend removing your gallbladder if you have any of the following symptoms or conditions:

  • Abdominal pain , especially after eating
  • Shoulder or back pain, particularly on the right side of your body
  • Inflammation of your pancreas

If you’re like most people, you can live a healthy life without your gallbladder.

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How Do Doctors Treat Gallbladder Problems

Taking the gallbladder out is usually the best way to treat gallbladder problems. You might get some relief from changing your diet. For example, eating less fat can help. But gallstones rarely go away on their own.

You might have heard about treatments to break up gallstones or make them melt away . Unfortunately, these do not usually work well.

What Is Robotic Cholecystectomy

Gallbladder Surgery for Gallstones

Your surgeon might use a surgical robot to do your operation. It is done the same way as the description above. Your doctor guides the robot instead of guiding the instruments by hand. This is commonly referred to as robotic surgery.

You might have a specialized X-ray of your gallbladder and bile duct during surgery. This X-ray can find gallstones in the common bile duct. If you have them, the surgeon might need to do additional procedures during the surgery. Or you might need another procedure to remove them later.

It is very important to know about your doctors training and experience before your surgery. Ask about their experience doing laparoscopic gallbladder removal and open gallbladder surgery.

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Who Is At Risk For Gallstones

Certain people have a higher risk of developing gallstones than others:2

  • Women are more likely to develop gallstones than men. Extra estrogen can increase cholesterol levels in bile and decrease gallbladder contractions, which may cause gallstones to form. Women may have extra estrogen due to pregnancy, hormone replacement therapy, or birth control pills.
  • People over age 40 are more likely to develop gallstones than younger people.
  • People with a family history of gallstones have a higher risk.
  • American Indians have genetic factors that increase the amount of cholesterol in their bile. In fact, American Indians have the highest rate of gallstones in the United Statesalmost 65 percent of women and 30 percent of men have gallstones.
  • Mexican Americans are at higher risk of developing gallstones.

Other factors that affect a persons risk of gallstones include2

More information about these conditions is provided in the NIDDK health topic, Insulin Resistance and Prediabetes.

Pigment stones tend to develop in people who have

  • cirrhosisa condition in which the liver slowly deteriorates and malfunctions due to chronic, or long lasting, injury
  • infections in the bile ducts
  • severe hemolytic anemiasconditions in which red blood cells are continuously broken down, such as sickle cell anemia

Can Diet Prevent Gallstones

Women who eat more fruits and vegetables are less likely to have their gallbladders removed than women who eat very little fresh produce, according to a 2006 study. Also, other sources of fiber such as the psyllium husks mentioned earlier may be beneficial for the gallbladder.

Foods that may cause gallbladder problems include:

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What Happens During A Cholecystectomy

You may have a cholecystectomy as an outpatient or as part of your stay in a hospital. The way the surgery is done may vary depending on your condition and your healthcare provider’s practices.

A cholecystectomy is generally done while you are given medicines to put you into a deep sleep .

Generally, a cholecystectomy follows this process:

  • You will be asked to take off any jewelry or other objects that might interfere during surgery.

  • You will be asked to remove clothing and be given a gown to wear.

  • An intravenous line will be put in your arm or hand.

  • You will be placed on your back on the operating table. The anesthesia will be started.

  • A tube will be put down your throat to help you breathe. The anesthesiologist will check your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.

  • If there is a lot of hair at the surgical site, it may be clipped off.

  • The skin over the surgical site will be cleaned with a sterile solution.

  • Recovery From Open Surgery

    SpyGlass technique blasts painful gallstones with powerful shockwaves ...

    Recovery from open surgery takes longer. A person can expect to stay in the hospital for 35 days after their operation. Hospitals require someone to pick up the individual to drive them home or take a taxi with them.

    It can take 68 weeks to make a complete recovery from open surgery and return to normal activities.

    Although gallbladder surgery is relatively common and safe, there are some possible side effects and complications.

    Some potential issues may include:

    • reactions to the anesthesia

    if any gallstones remain in the bile duct. It may also occur if bile leaks into the stomach. The symptoms of PCS are similar to those of gallstones and include abdominal pain, diarrhea, and heartburn.

    Anyone who notices any of the below symptoms after gallstone removal surgery should visit a doctor.

    • pain that worsens or does not get better over time
    • new abdominal pain
    • an inability to pass gas or have a bowel movement
    • ongoing diarrhea
    • yellowing of the skin, called jaundice

    If a surgeon cannot remove the stones readily with maneuvers during the surgery, a person may need a procedure called endoscopic retrograde cholangiopancreatography . A gastroenterologist passes a camera down from the persons mouth up to the first part of their small intestine where the bile duct inserts. They then access the duct from there to try and remove the stones.

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    Medicine To Dissolve Gallstones

    If your gallstones are small and don’t contain calcium, it may be possible to take ursodeoxycholic acid tablets to dissolve them.

    But these aren’t prescribed very often because:

    • they’re rarely very effective
    • they need to be taken for a long time
    • you can get gallstones again after treatment is stopped

    Side effects of ursodeoxycholic acid are uncommon and are usually mild. The most commonly reported side effects are feeling sick, being sick and itchy skin.

    Ursodeoxycholic acid isn’t usually recommended for pregnant or breastfeeding women.

    Sexually active women should either use a barrier method of contraception, such as a condom, or a low-dose oestrogen contraceptive pill while taking ursodeoxycholic acid, as it may affect other types of oral contraceptive pills.

    Ursodeoxycholic acid tablets may occasionally be used to prevent gallstones if it’s thought you’re at risk of developing them.

    For example, ursodeoxycholic acid may be prescribed if you have recently had weight loss surgery, as rapid weight loss can cause gallstones to grow.

    Recovery From Laparoscopic Surgery

    After a laparoscopic procedure, most people can leave the hospital on the same day as the surgery. However, a friend or family member will need to drive the individual home after surgery or accompany them in a taxi.

    It is also important to rest and avoid strenuous activities for up to 2 weeks, but a person should be able to return to normal activities after this time.

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    What Are The Benefits Of This Type Of Surgery

    Laparoscopic gallbladder removal has many advantages. Unlike traditional surgery, laparoscopic surgery can be done without cutting the muscles of your abdomen. This may allow you to:

    • Have less pain after surgery
    • Have a shorter hospital stay
    • Have a shorter recovery time
    • Return to work more quickly

    Have much less noticeable scars than with a traditional cholecystectomy

    Thinning Bile With Acid Pills Can Dissolve Gallstones

    Gallbladder and Gallstone Removal Surgery: Day of Surgery

    In some cases, gallstones can be treated with medicine.

    Certain chemicals, such as ursodiol or chenodiol, which have been shown to dissolve some gallstones, are available in oral bile acid pills. These medicines work by thinning the bile, which allows gallstones to dissolve.

    While these pills can be effective and are generally well tolerated by patients, medical treatment of gallstones is limited to people whose stones are small and made of cholesterol. But according to Mount Sinai, these drugs can take two years or longer to work, and gallstones may return after treatment ends.

    Decreasing the cholesterol content of the bile can dissolve , but its not effective enough that we dont refer patients to surgery, Dr. Kumta says.

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    What Are The Major Risks Of Laparoscopic Cholecystectomy

    Cholecystectomy is usually a fairly simple and low risk procedure. However, the following risks can occur:

    Infection

    An infection can occur after any type of abdominal operation and occurs in around 1 in 15 cholecystectomies. Both simple wound infections and infections inside your abdomen can be treated with a short course of antibiotics. This most commonly affects the wound near your belly button, as this is the largest wound for the camera and where the gallbladder is removed from.

    Bleeding

    Bleeding can occur after your operation, although this is rare.

    Bile leakage

    When the gallbladder is removed, special clips are used to seal the tube that connects the gallbladder to the main bile duct, draining the liver. However, bile fluid can occasionally leak out. Sometimes this fluid can be drained off by a radiologist inserting a drain guided by ultrasound. Occasionally an operation is required to drain the bile and wash out the inside of the abdominal cavity. Bile leakage occurs in around < 1% of cases.

    Injury to the bile duct

    Injury to intestine, bowel and blood vessels

    The keyhole instruments used to remove the gallbladder can injure surrounding structures, such as the intestine, bowel and blood vessels. The risk is increased if the gallbladder is inflamed. This type of injury is rare and can usually be repaired at the time of the operation. Sometimes injuries are noticed afterwards and a further operation is needed. Luckily these complications are rare.

    Diarrhoea

    What Happens Before Gallbladder Removal

    A few weeks before surgery, you meet with your healthcare provider. At this appointment, you may:

    • Get a blood test to make sure you’re healthy enough for surgery.
    • Discuss what technique your surgeon will use and ask any questions.
    • Receive instructions about when to stop eating and drinking before your operation.
    • Talk about ways you can reduce your risk of postoperative complications, such as quitting smoking.

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    Small Gallstones Can Be Broken Apart With Shock Waves

    Another nonsurgical treatment for which gallstones must meet certain criteria is extracorporeal shock-wave lithotripsy . Although it is most commonly used to treat kidney stones, it can also be used on gallstones. The goal of the treatment is to break up, or fragment, gallstones by sending shock waves through the soft tissue of the body.

    This method is only effective on solitary gallstones that are less than 2 centimeters in diameter, so fewer than 15 percent of patients are eligible for ECSWL. A case report published in 2017 in the International Journal of Surgery Case Reports found a low success rate for ECSWL patients with multiple gallstones. Even when stones are fragmented, a diseased gallbladder may not expel the fragment.

    According to research published in the October-December 2014 issue of the Journal of Indian Association of Pediatric Surgeons, for this form of treatment, children may be the best candidates.

    Gallbladder Removal: Laparoscopic Method

    Gallbladder Surgery Single

    Last Updated August 2022 | This article was created by familydoctor.org editorial staff and reviewed by Kyle Bradford Jones

    The gallbladder is a small, pear-shaped organ just under your liver. It stores bile, the digestive fluid the liver makes to digest fat. Sometimes the gallbladder gets inflamed. This happens when the flow of bile is blocked. This can be caused by gallstones , injury, or other conditions. When this happens, you may experience pain and other symptoms. Your doctor may want to remove your gallbladder. Fortunately, we dont need our gallbladders to live. And removal usually doesnt cause complications.

    It is important to note that not all people who have gallstones require surgery to remove their gallbladder. Your doctor will help decide which course of action is best for you and your symptoms.

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    How Can I Help Prevent Gallstones

    You can help prevent gallstones by

    • adjusting your eating plan to include more foods high in fiber and healthy fats, fewer refined carbohydrates, and less sugar
    • losing weight safely if you are overweight or have obesity
    • maintaining a healthy weight through healthy eating and regular physical activity

    What Can I Expect After The Procedure

    You will be monitored in recovery for some time and will normally be able to go home within 24 hours. You may have some side effects from the general anaesthetic such as a headache, nausea or vomiting, which can be controlled with medicine.

    You will have some pain in your abdomen after the operation, which can be controlled using pain relief. You may also have some pain in your shoulder from the gas used in the operation, which can be eased with walking.

    You will have a drip in your arm at first, which will be removed after the anaesthetic wears off. You can take sips of water at first then slowly get back to eating and drinking normally.

    Your wounds will have clips or stitches and you may also have a drain in your side to allow fluid to leave your body. This is usually removed the next day. Make sure you keep your wounds clean.

    You will be tired at first. Do not drive for the first 7 days, smoke or lift heavy weights. You can expect to recover fully and return to your normal activities within 2 weeks.

    Contact your doctor immediately if you have:

    • a lot of discharge from the wounds
    • pain that can’t be controlled by pain relief medicine
    • swelling, tenderness or redness in the abdomen
    • yellow eyes or skin

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