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Laparoscopic Cholecystectomy ( Gallbladder Stone Surgery)

Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallbladder stone and inflammation of the gallbladder.

Very small (1cm and ½ cm) incisions are made through which the surgeon introduces a laparoscope (lens) and specialized instruments to perform the extraction of the gall bladder. This is a safe procedure that provides several benefits in the post-operative period. This includes less pain, faster recovery, lower infection rate and less chances of incisional hernias. It also leads to faster return to normal activities.

What is gall bladder?
The gallbladder is a pear shaped organ located in the upper right part of the abdomen, below the liver. Its main function is to store bile produced by the liver. The bile is released by the gallbladder in large amount after a large and fatty meal.

What are 'Gallbladder stones'?
Cholelithiasis or gall bladder stones, mean the formation of stones in the gall bladder. These stones are formed by the precipitation of cholesterol crystals due to an alteration in the ratio between bile salts, calcium salts, bile pigments and cholesterol. This is a frequent occurring condition. The function of gallbladder is already impaired when patients are having symptoms related to gall bladder stones.

What are the Symptoms?
Patients with gallbladder stones can be totally asymptomatic (without discomfort) for a long time. Once there are symptoms, it can be billiary colic that is manifested with pain in the upper right quadrant of the abdomen (upper part of the stomach and liver), which can extend to the back. This pain can last between 2-4 hours and then it can disappear completely. This pain occurs when the stone blocks the opening of the gallbladder leading to stretching of its walls. Pain goes away if the stone falls back in gallbladder letting the bile out of it. If the block continues it leads to a complication called acute cholecystitis. In such a situation the pain persists for more than 24 hours. It may be associated with fever , jaundice and vomiting. Gallbaldder stone can also cause dyspepsia (feeling of indigestion).

Who needs Surgery and why surgery is necessary?
All patients who had an episode of pain in the right side of abdomen, who have chronic problems with indigestion, who had an episode of jaundice or pancreatitis related to gall bladder stones needs surgery. Surgery helps in prevention of gallbladder stones related complications like jaundice due to passage of stone in the bile duct, acute pancreatits, acute cholecystitis ( inflammation of Gallbladder) and Gall bladder Cancer. Some of these complications are life threatening and it is much easy and safe to remove gallbladder than managing these complications. So the main purpose of surgery is to prevent complications. Those having episodes of pain, those with diabetes and already had any of these complications are at high risk of further complications and so such patients should get surgery done at earliest. Dr Chirag Thakkar is a leading Laparoscopic surgeon of ahmedabad with large no of surgeries performed till now.

How is it diagnosed?
Ultrasound is the most commonly used method for the diagnosis of gall bladder stones. In patients with any of these complications CT scan of abdomen or MRCP may be required. If needed we will advise you to get it done.

What is the treatment for Gallbladder stones?
The treatment for cholelithiasis or gall bladder stones is exclusively surgical. Whole of gallbladder is removed as a part of this surgery. Unlike kidney stones, for gallbladder stones removing only the stones does not cure the condition. Stones are bound to form again if gallbladder is not removed. It is important to understand that gallbladder itself is not functioning properly in patients with gallbladder stones so it is necessary to remove gallbladder to cure the problem.

Does removal of Gall bladder cause indigestion?
There is no change in digestion after removal of Gallbladder. Once you are having symptoms due to gallbladder stones, your gallbladder as such is not functioning properly. Removing this non functioning gallbladder is not going to add to your indigestion. Bile still goes to your intestine for digestion from liver. A large quantity of bile required after a large and fatty meal will not go to intestine at once. So we will advise you to have small and frequent meals and avoid large and fatty meals. This dietary change is necessary even if you do not get you gallbladder removed.

What dietary changes are required after surgery?
There are no specific restrictions to diet. You need to eat small quantity more frequently than having large meals. You need to avoid very fatty food , spicy food and fried foods. These are the dietary advice that should ideally be followed by all as measure to improve overall health. After surgery you can have everything in moderation.

What are the risks involved in this surgery?
As with any surgery there are risks involved with surgery and anaesthesia. This is more so with elderly people and those having heart, lung , kidney or liver diseases. Thus emphasis should be placed on proper evaluation before surgery, and if your are having any such medical problems you should plan to be operated in a hospital with facilities for other specialities available.

How long have I to stay in hospital?
You can be discharged on the same day of surgery if you feel comfortable. We will prefer to keep you in hospital on the night of surgery and send you home the next day morning. Exceptions are when you have other problems like heart , lung or kidney diseases and require some treatment or monitoring for these conditions. Then you may need a couple of days in hospital.

When can I resume work?
You can resume routine household and office work a couple of days after surgery once you are comfortable. Most of the patients resumes their work by the end of a week. You should avoid heavy work like lifting and heavy exercise for 6 weeks. You can have a shower from the next day of surgery and can drive a car after couple of days as you are comfortable. You can walk as much as you can and can climb a couple of flight of stairs. Usually there are no stitches to be removed, you just need a wound dressing in follow up consultation. Dr Chirag Thakkar is highly experienced and had a high end training in laparoscopic surgeries. He is having experience of thousands of such surgeries with very good results.

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Gallbladder Stone Surgery

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