Gallbladder Stones and diagnosis by Endoscopes

Background:-

CHOLELITHIASIS means stones in gallbladder. These days it is a common problem in general population. Gallstones can sometimes come out of the gallbladder and get trapped in common bile duct and obstruct the flow of bile from liver and gallbladder to small intestine (duodenum). Thus leads to severe pain and feeling of fullness in abdomen.

Symptoms:-

Following symptoms may occur in CHOLELITHIASIS.

– Nausea and vomiting

– Abdominal pain

– Indigestion

– Jaundice (yellowish sclera)

– Pale stool

– Anorexia

Diagnosis:-

– Ultrasound of whole abdomen, CT abdomen

– ERCP (Endoscopic Retrogradecholangio Pancreatography)

– Blood reports

Treatment:-

It’s treatment includes surgery after reducing pain with NSAIDs (Non-steroidal anti-inflammatory drugs) and antibiotics. Surgery involves removal of gallbladder with stones. Earlier it was done through a large incision on Abdomen (open cholecystectomy). Nowadays, with a help of endoscopic techniques, surgery (Laparoscopic cholecystectomy) become easy and safer. It requires 3 to 4 small holes to perform the procedure.

Preparation before surgery:-

– You should have your all investigations done as advised by your surgeon.

– You have to be empty stomach for 6-8 hours.

– Take a shower nicely with antiseptic soap on your surgery day.

How it is performed?

The surgery is performed by surgeon having specialisation in laparoscopic surgeries.

It involves following steps,

  • Surgery is done under general anesthesia.
  • Sterilization of part (abdomen)
  • Surgeon make a keyhole in your abdomen just below umbilicus. Then, insert a trocar (hallow, tubular metallic instrument) to make a port and inflate you abdomen with carbon dioxide to visualize the internal organs clearly. In the same port, a rigid laparoscope (tubular metallic with lenses and light attached to camera) is inserted, with help of this internal organs can be seen on monitor.
  • Other ports are made guided by camera for the insertion of other surgical instruments like scissors, hook, clamp, suction etc.
  • With the help of surgical instruments gall bladder is removed along with stones.
  • Abdomen is deflated after the procedure to avoid abdominal distension.
  • Repairing of incisions and dressing done.
  • General anesthesia usually lasts less than 2 hours, so you get conscious in 2 hours.

When to resume to normal diet?

Within 6-8 hours you can start with you liquid diet followed by semi-solid diet. By next day you can start with normal diet provided meal have low fat and less spices in it.

After surgery your body can no longer store bile as gall bladder is removed, this has little or no effect on digestion. Some may experience indigestion and heart burn for few days.

Why Laparoscopic surgery is preferred?

  • It require small incisions.
  • Decreases duration of hospital stay.
  • Recovery is faster.
  • Decreases the complication rate.
  • No exposure of internal organ to outside environment.
  • Less use of instruments.
  • Less haemorrhage.

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