Gallbladder Removal Surgery

The gallbladder is a pear shaped organ which is a part of the human digestion system, just right below the liver. Gallbladder main function is to store and transport bile. Bile is yellowish brown fluid, a combination of Fat and Cholesterol, which is produced by the liver.

During the meal, bile is traveled to the gallbladder where bile is stored and released until use. Bile is used to break down fat from the food in the small intestine. Bile helps vitamins and nutrients to be absorbed into the bloodstream. A gallbladder can store in between 30 and 80 milliliters of bile.

Usually, people do not care about the gallbladder until they face the problem associated with the gallbladder. However, the gallbladder is not necessary for human survival as bile can reach the small intestine in other ways. But when a gallbladder problem arises, it could be painful and require immediate action. The problems with Gallbladder can be billiary colic, Gallstone, cholecystitis, pancreatitis, and cholangitis.

Types of Gallbladder problems

Disease which affects gallbladder is considered as gallbladder disease or problem. The following are the conditions of all type of gallbladder diseases.

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Inflammation of the gallbladder :

Inflammation of the gallbladder tissue is called cholecystitis, usually may cause of pain in the upper right abdomen and which can radiate to shoulder or back. It can also give tenderness to the abdomen when it is pressed or touched. It can be either short-term or long-term. This type of inflammation results in several acute cholecystitis attacks which damage the gallbladder or make it unable to function correctly.

Gallstones:

Gallstones are small solid pigments, which develop on its own and not be detected for many years until they cause problem or pain. Usually, most stones are formed from the fat or cholesterol in the bile. But some type of gallstone like pigment stone is formed from calcium bilirubinate. When your body breaks down RBC(red blood cells), a chemical is produced which cause Calcium bilirubinate. This type of stone is rare.

Common bile duct stones :

Common bile duct stones (Choledocolithiasis) are gallstones that is present in the common bile duct. This may be developed in the gallbladder and then passed into the bile duct. These types of stone are called a secondary common bile duct stone. It can block the flow of bile and make the gallbladder inflamed or distended.

Gallbladder disease without stones

Gallbladder disease without the stones are Acalculous Cholecystitis, which has the similar symptoms as gallstone. In this case, Gallbladder muscles and valve are not working and this type of complication occurs in serious disorder like Trauma or burns which may not appear easily.

Common bile duct infection

An infection may develop if the common bile duct is blocked by a gallstone. The infection can be caused by bacteria which can spread and cause a tumor.

Abscess of the gallbladder:

Gallstones that develop pus in the gallbladder is called empyema. Pus is a combination of white blood cells, bacteria, and dead tissue. The development of pus in the gallbladder leads to abdominal pain. If the condition isn’t diagnosed and treated, the infection can spread to other parts of the body and it could be life-threatening.

Perforated gallbladder:

If the gallstone is not treated, gallstones can be a reason for a perforated gallbladder that can be life-threatening. It also can develop an infection if not detected.

Gallbladder polyps:

Polyps are growths in the gallbladder that develop. These are noncancerous and Small gallbladder polyps need not be removed. They are not harmful until they are really large in size as larger polyps may cause to develop cancer.

Porcelain gallbladders:

Porcelain gallbladder is the condition in which the gallbladder wall is stiffened by calcium. People whose gallbladder is developing this type of problem, are on higher risk of gallbladder cancer.

Gallbladder cancer:

Gallbladder cancer is very rare, but it easily spread in the gallbladder also in the other part of the body, if it is not detected or treated. The symptoms of the gallbladder cancer are similar to other gallbladder problems like nausea, vomiting, jaundice, fever.

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Symptoms of a Gallbladder problem

Pain in abdomen: Pain is the most common symptom of the gallbladder problem. It may occur from mild and irregular to very severe in the mid and upper abdomen. Gallbladder pain can also affect the other part of the body like chest and back.

Nausea or vomiting: The common symptoms of all types of gallbladder problems are Nausea and vomiting. But in the long term of the gallbladder diseases may lead to the digestive problem which could be also for long period.

Fever: Fever may give you a signal of an infection in the body. If you have an infection, it can worsen and become dangerous.

Bowel movement: Unexplained bowel movement, having more than four bowel movements per day for at least three months may be a sign of chronic gallbladder disease.

Jaundice: Body colour also gives you a signal, when Bile is not able to reach the intestine. Skin gets paled due to the blockage of the bile duct. This blockage is caused by the gallstone.

Change in stools or urine colour: Urine and stool colour are also the sign of gallbladder problem. Dark urine and light coloured or chalky stool may point to a blocked duct of bile.

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When to see a doctor?

If anyone sees any of the above-mentioned gallbladder symptoms, should seek medical attention. Mild pain, that goes away on its own, does not need immediate attention. If the symptoms are more severe and include the following, a patient should take an appointment immediately:

• Upper-right quadrant pain that does not go away within 5 hours
• Fever, nausea, or vomiting
• Changes in bowel movement and urine

This combination of symptoms can indicate a serious infection or inflammation that needs immediate treatment.

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Diagnosis

If a patient is suspected of a gallbladder problem, the doctor may advise you the following:

• Ultrasound and CT scans are commonly used to image the gallbladder.
• Tests to check the bile ducts for stones include MRI, hepatobiliary iminodiacetic acid (HIDA) scans, and an endoscopic retrograde cholangiopancreatography (ERCP).
• Blood tests to reveal signs of infection, inflammation of the bile ducts, pancreatitis, or other complications caused by gallstones.

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Gallbladder Treatments

Gallbladder surgery or Cholecystectomy: The most common procedure in which a surgeon removes the gallbladder completely known as Cholecystectomy. Surgery can be done by three different methods using either laparoscopy or laparotomy.

Open (traditional) method:

This surgery performed under local anaesthesia After patient anesthesia administered patient belly cleaned to avoid any infection. The surgeon after makes 4 to 6-inch incision to the patient upper right side of the abdomen. And then gallbladder carefully removed. With open surgery, the patient will likely be in the hospital for 2-3 days.

Laparoscopic Gallbladder Removal Surgery:

Also, this surgery performed under local anaesthesia. Laparoscopic Gallbladder removal surgery, a surgeon typically insert three to four near about  5 to 10 mm small incisions in the abdomen area and carefully remove a gallbladder. This surgery usually takes 1- 2 hours of time.

In this surgery method, less pain and less bleeding happen compare to open surgery. The patient can return home on the same day but sometimes may need to stay in the hospital in the night.

Laparoscopic gallbladder removal surgery requires less recovery time and has a lower risk of infection compared to the traditional open surgery. The patient can Recovery time takes a week to fully recover.

Single‑incision laparoscopic cholecystectomy (SILS)Laparoscopic Gallbladder Removal Surgery :

In this method, the surgeon removes the Gallbladder through a single incision in the abdomen area.

Why SILS is better than Standard laparoscopic cholecystectomy

• Very less pain
• Shorter Recovery Time
• Very few wound complications
• No Scar
• Use Single Incision
• Advanced Latest Technology
• Very Safe
• The patient can return on the same day.

Dr Mir Asif Rehman is the only Laparoscopic surgeon in Gurugram who are performing such kind of surgery.

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Gallbladder Surgery Complications

Gallbladder removal is a common procedure that rarely results in severe complications.

The surgery often causes disruption in your digestive system for a period of time, but this is an expected side effect of the procedure and shouldn’t be alarming.

In some cases, though, more severe complications develop, such as bile leaking into the abdominal cavity, injury to a bile duct, and attacks of pain in the area. These can occur on top of general surgery complications like infection, bleeding, blood clots, and scarring.

You shouldn’t hesitate to contact your doctor if you experience any signs of a complication that may need treatment.

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Diet for a healthy gallbladder

For a healthy gallbladder, you should maintain a healthy lifestyle and well-balanced diet that are good for gallbladder:

• Have fruits and vegetable which are high in fiber and vitamin C, because lacking in these ingredients can lead to gallstone. Radishes are prohibited for patients, who have gallbladder issue.
• Fish, pork, lamb and skinless chicken are also good choices for healthy gall bladder.
• Include oats, bran cereal and brown rice in your diet.
• Take low fat food and dairy product.
• Caffeine from coffee can reduce the risk of gallstone but caffeine from tea is not beneficial.
• Take proper amount of water.
• Eating peanuts or tree nuts such as almonds and walnuts in a proper amount are helpful in preventing gallstones.
• Reduce carbohydrate and sugar intake.

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