Gallstones: What You Need to Know about Gall Bladder and Bile Duct Treatment
The gallbladder is a small pear-shaped organ that is part of the digestive system and is located just below the liver. It functions to store and releases bile produced by the liver in the digestive system while eating. Bile juice or bile contributes to the breakdown of fat in the food we consume. In a healthy individual, bile moves smoothly through the digestive system.
However, there is a gallbladder and biliary tract condition in which large amounts of cholesterol coagulate to form a hardened mass in the form of pellets called gallstones. If this happens to you, you probably have many abdominal issues and it is best that you see a doctor. Biliary obstruction carries the risk of infection and inflammation of the gallbladder and biliary tract.
The most common symptoms of gallbladder bile duct problems are heavy cramping and abdominal pain which may become permanent, back pain, nausea and vomiting, unpleasant belching, fever, and chills. These issues can worsen over time and are often triggered by the consumption of certain foods. Eventually, yellowing of the skin and whites of the eyes may occur and patients may exhibit fully lightened stools and urine that is unusually dark.
The process for diagnosing gallstones begins with a thorough examination by the doctor. During the examination the doctor gently presses the abdomen to feel for an increase in the size of the gallbladder. The doctor examines the tongue and the eyes. Based on the results of the examination, the doctor orders blood and urine tests. The most important test in this case is an abdominal ultrasound. It shows whether there are or are not stones in the gallbladder and bile ducts, the condition of the wall of the bladder, and whether there are any complications.
Very rarely, if the ultrasound provides evidence that there is an complication, I may ask for a diagnostic/therapeutic procedure called ERCP (endoscopic retrograde cholangiopancreatography) to be performed at the same time. This will allow me to gain virtually certain understanding of what is happening in the area of interest. This is accomplished by means of a long optical tool which is inserted through the mouth and down the throat to the duodenum. It then injects a contrast agent into the biliary tract which is monitored by X-rays. Then, if stones exist in the bile ducts, an incision is made at this time in the muscle that holds them there. This procedure is successful over 95% of the time. It can prevent many subsequent major surgeries with only the removal of the gallbladder. But remember, it applies only to biliary tract stones.
The best treatment for the removal of gallstones and the prevention of the formation of new ones is the surgical removal of the bladder with the stones. Remember that like the appendix and spleen, the gall bladder is an organ that people can live without. The absence of the gallbladder does not inhibit digestion; without it, bile simply passes directly from the liver to the small intestine. In cases where there are stones in it and it does not function, it is unable to shrink or empty itself when necessary.
Every year about one million Americans undergo gallbladder removal surgery because it is irritated and contains stones. The medical term for this operation is cholecystectomy.
Conventional or open surgery becomes an option on the table these days depending mostly on accompanying ailments and previous operations. Carefully inserted into the abdomen, the endoscope is the tool of choice when the patient has undergone several operations or sustained extensive injuries to the abdomen. In these cases, the location and extent of adhesions is unknown and the potential for damage that could be caused during entry into the abdomen is unjustified. Therefore, a traditional operation is much safer. Sometimes, even in these cases, laparoscopic surgery is offered, but at the expense of time: Why draw it out for three or four hours when everything can be completed in just over an hour? Minimally invasive surgery should not be an end in itself. In fact, even though scarring is greater, this procedure is the better choice.
The laparoscopic technique used to remove the gallbladder is the gold standard today for cholecystectomy. Laparoscopic surgery is performed through several tiny incisions with special instruments. A small video camera called a laparoscope allows viewing of the operation on a large monitor where the smallest details can be seen in high definition. Again, this involves the same techniques as in open surgery: making incisions and sewing, but on a much smaller scale. The great advantages of this operation are almost no blood loss, negligible pain after surgery, lower risk of infection of operational wounds, and shorter recovery time afterwards. In recovering after laparoscopic surgery, with common sense and moderation, one can return to normal functionality in three to seven days after surgery. If you perform physical work, you will have to wait approximately 30 to 40 days, but even this is far less than the three to four months that traditional surgery requires.
It is important to be aware that during any laparoscopic surgery it may be necessary to transition to an open surgery. This is called conversion. I explain this in detail before surgery, because in medicine and surgery nothing is 100% certain. While it is absolutely certain that we will all die, do not forget that one rose from the dead. Still, I cannot promise with total certainty that everything will end the way it was intended to in the beginning.
I want and I always try to achieve the best possible outcome for my patients. An approach tailored to solving each individual’s unique problems through my knowledge and skills gives me confidence in the fact that I that I almost always achieve this goal.