Cholecystectomy​

//Cholecystectomy​
What is the Gallbladder?

The gallbladder is located under the liver in the right upper abdomen.
Its main purpose is to collect and concentrate bile produced by the liver. The gallbladder stores bile and the squeezes it into the small intestine to help digest fatty meals.  Bile travels through narrow tubular channels (bile ducts) into the small intestine.

Gallbladder

What Causes Gallbladder Problems?
Gallbladder problems are usually caused by gallstones.
Gallstone form from an imbalance in the concentration of cholesterol and bile chemicals.

It is uncertain why some people form gallstones but risk factors include being female, prior pregnancy, age over 40 years, being overweight and having a family history of gallstones. There is nothing you can do to prevent gallstones.

Problems occur when these stones may block the flow of bile out of the gallbladder, causing it to swell and resulting in sharp abdominal pain, vomiting, bloating and, occasionally, fever.
If the gallstone passes, it can block the common bile duct and jaundice (a yellowing of the skin) can occur.

 

How are These Problems Diagnosed?
Ultrasound is a very simple test and the most commonly used to find gallstones.
Sometime the stones are seen on a regular x-ray but most cannot be seen on plain x-rays.

How are Gallbladder problems treated?
Surgery is the only effective treatment for gallstones.
There are no good medications to dissolve the stones.
You will find “Gallbladder flushes” on the internet. Don’t waste your time and money on these. They don’t work.  Gallstones don’t pass the way kidney stones do and you don’t want them to pass!  When a stone does pass from the gallbladder it usually causes major problems like jaundice, pain and inflammation of the pancreas.
What does Gallbladder Surgery Involve?
The operation required is the removal of the entire gallbladder.  Just removing the stones results in the gallbladder making more stones and the problem coming back. No one performs that procedure, no matter what you have heard from friends or family.
The gallbladder can be removed laparoscopically with just 4 small incisions.  Sometimes it can be done with only one incision hidden in the umbilicus.
The operation is typically a same day, one hour operation.  The patient has the operation and goes home the same day.
What Can You Expect After Gallbladder Surgery?
The gallbladder does not make the bile, the liver does.  Removal of the gallbladder is not associated with any impairment of digestion in most people.
You will be able to eat whatever you want because the gallbladder is not there to bother you anymore.
Removing the gallbladder does not make you lose or gain weight.
There are minimal restrictions afterwards.  Patients can essentially resume normal activities.

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Intraoperative Cholangiogram
During surgery to remove the gallbladder (cholecystectomy), I perform  a procedure called intraoperative cholangiogram. This is a dye test to examine the bile ducts.  This allows me to Look for gallstones that may be have escaped the gallbladder  into  the common bile duct.  It also allows me to see the anatomy of the bile duct system from the liver to the small intestine. Viewing the bile ducts before removal of the gallbladder minimizes the risk of accidentally cutting or damaging the common bile duct.

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Common Bile Duct Exploration
About 10 to 15% of patients will have a stone that passed into the common bile duct.  That stone can block bile from exiting into the intestine causing infection and jaundice.  It can also block the opening to the pancreas causing inflammation of the pancreas or pancreatitis.  Pancreatitis can be very painful and life threatening.  To get then stone out, most surgeons convert the surgery to open or schedule the patient for another procedure called an ERCP.  But, Dr. Zahriya is skilled in laparoscopic common bile duct exploration and the stone can usually be removed at the time of the gallbladder operation.

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Single Site Cholecystectomy
We now offer a new laparoscopic procedure that offers cosmetic advantages while maintaining the tradititional benefits of laparoscopic gallbladder removal.  The procedure is identical to traditional laparoscopic gallbladder removal except that the surgeon makes just one tiny incision instead of four.
In single-incision surgery, the camera and all of the instruments are inserted through a one inch incision within the navel. Thus, the patient recovers with a single, hidden, almost invisible, scar in the umbilical area.

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