GALL BLADDER STONES SURGERY

Gallstones are stone-like objects that most commonly develop in the gallbladder which is a small organ tucked up under the liver, on the right side of your body. It is shaped like a pea pod & is green in color due to the bile inside. Its job is to store and dispense bile—a fluid made by liver that helps digest fats in the fats/food you eat. The gallbladder, even if removed causes no observable problems in a healthy individual. Sometimes diarrhea and fat malabsorption are noticed in people that have their gallbladder removed by surgery.

Gallstones size can vary from like tiny grains of sand to few centimeters size stones. These are made of contents of bile like cholesterol or bile pigments. . 

 WHY YOU DEVELOP GALL STONES 

Below are some of the general factors that lead to gallstones:

  1. Obesity is one of the leading causes of gall stones formations in gall bladder
  2. More commonly gallstones develop in females above 40 years especially if obese. Pregnancy is also one of the risk factors.
  3. High cholesterol diets, refined carbohydrates as well as eatable consisting body fats like cheese, butter, and red meat also can cause gallstones.
  4. A sedentary lifestyle is also one of the risk factors of gallstones.
  5. Diabetes, cirrhosis, Crohn’s disease, metabolic syndrome, and various other can cause gallstones.
  6. Also rapid weight loss (like after bariatric surgery) can cause gall stones.

WHY SHOULD YOU GET TREATMENT FOR GALL STONES?                         
WHAT ARE THE COMPLICATIONS OF GALLSTONES?

To avoid further complications, you should get proper treatment of gall stones earliest There are several complications of a gallstone attack, including:

  1. Bloating.
  2. Nausea and vomiting.
  3. Abdominal pain.
  4. Shoulder pain.
  5. Back pain.
  6. Chest pain.
  7. Jaundice
  8. Pancreatitis
  9. Cancer of gall bladder

POSSIBLE SYMPTOMS that can tell you that you may have gall stones 

Biliary colic (intermittent duct blockage): in this, you experience a sudden and rapidly increasing pain with or without nausea & vomiting in several places like 

  1. Upper part of the abdomen, on the right side.
  2. Between the shoulder blades.
  3. Under the right shoulder.

The symptoms may also include along with pain.

Pain is the most common symptom most people experience with gallstones. This pain can be mild to severe and can last from around 15 minutes to several hours.  Gallstones can cause acute cholecystitis, which is a more serious condition when the gallbladder is actually inflamed.  This may require antibiotics, hospitalization and even urgent surgery. Sometimes stones can pass out of the gallbladder and into the common bile duct can cause a complete blockage of the duct with jaundice, infection and pancreatitis which is an serious emergency.

HOW ARE GALLSTONES DIAGNOSED?

  1. Best & most diagnostic test is Abdominal ultrasound: quick & simple test done by radiologist best done in 6-8 hours of fasting state and is considered to be a perfect test for detecting gallstones.
  2. Magnetic resonance cholangiopancreatography (MRCP): his test makes use of an MRI scanner to produce high-resolution images of the bile ducts, pancreas, and gallbladder. These images are used for further tests and treatments.
  3. Abdominal X-ray: Although they may be used to look for other problems in the abdomen, X-rays generally cannot diagnose gallbladder disease. However, X-rays may be able to detect certain gallstones if radiopaque.

 LAPAROSCOPIC CHOLECYSTECTOMY

Dr Girish offers Gall stones treatment by latest techniques & he is one of  most experienced (30 yrs of experience in surgery &  laparoscopy ) surgeon in Dubai 

It can bunder your existing insurance .

The laparoscopic cholecystectomy remains the safest procedure for the removal of the gallbladder to treat gall stone disease. The advanced skills and the experience of the surgeon is the most important factor to prevent or reduce chances of complications to minimal .

This procedure uses 3-4 small cuts to give access into the abdominal cavity in order to remove the gallbladder. Using laparoscope (camera) enables us to inspect the abdominal cavity and perform surgery.

On the other hand, a single incision laparoscopic cholecystectomy (SILC) is a new technique being used by surgeons. We still lack long-term studies, and analysis regarding this technique.

It is part of single incision laparoscopic surgery (SILS) to use one retractor with three holes instead of 3-4 trocars to minimize the trauma and reduce the number of scars. This technique still did not gain popularity.

Another technique is the NOTES operation. The Natural Orifice Transluminal Endoscopy Surgery is a technique in which surgeon uses a natural orifice, for example stomach or vagina, to get access to abdominal cavity without external incisions or scars. It is still an experimental technique & you will not have any external scar.

Dr Girish treatment plan for gallstones treatment depends on how the symptoms are affecting your daily life.

*If you don’t have any symptoms, active monitoring is often recommended. This means you won’t receive immediate treatment, but you should let your doctor know if you notice any symptoms.

**Non-surgical treatments for gallstones

  1. There are medications that can be used to dissolve the stones especially tiny & made of cholesterol . Dissolving medications can take long time & high rates of failure & recurrences are there. Also, medicines have side effects.

Lots of patients after weight loss surgery by Dr Girish who developed gall stones have benefitted with this treatment.

*** surgical treatments for gallstones (cholecystectomy) 

Surgery by latest techniques is offered by Dr Girish which  includes

Surgical pearls 

  1. *The gallbladder isn’t an essential organ and you can lead a normal life without one.
  2. *As a general rule, the longer you go with symptoms, the more likely it is that your condition will get worse & surgery will be difficult.

Surgery (removal of gall bladder with stones) Can be done using different methods 

  1. LAPAROSCOPIC 
  2. SILS 
  3. NOTES 

The laparoscopic cholecystectomy remains the safest & most commonly used technique procedure for the removal of the gallbladder. The advanced skills and the experience of the surgeon is the most important factor

On the other hand, a single incision laparoscopic cholecystectomy (SILC) is a new technique being used by surgeons through single large cut but high rate of postoperative hernia occurrence & less safety are pushing this technique out of favor.

Another technique is the NOTES operation. The Natural Orifice Transluminal Endoscopy. It is still an experimental technique.

Keyhole surgery (laparoscopy) to remove the gallbladder

If surgery is recommended, you’ll usually have keyhole surgery to remove your gallbladder. This is known as a laparoscopic cholecystectomy.

During a laparoscopic cholecystectomy, 3 or 4 small cuts are made in your abdomen.

Your abdomen is temporarily inflated using carbon dioxide gas. This is harmless and makes it easier for the surgeon to see your organs by creating space inside.

A long, thin telescope with a tiny light and video camera at the end) is inserted through one of the cuts in your abdomen, which allows your surgeon to view the operation on a video monitor. They’ll remove your gallbladder including gall stones using special surgical instruments.

If gallstones are found, they may be removed during keyhole surgery. If the operation can’t be done this way, or an unexpected complication occurs, it may have to be converted to open surgery.

After the gallbladder has been removed, the gas in your abdomen escapes through the laparoscope and the cuts are closed with dissolvable stitches and covered with dressings.

The operation takes about one hour and you can usually go home the same day or next day morning.

Full recovery typically takes around 07 days.

Open surgery (Cholecystectomy) – now a days rarely indicated if 

  1. Having severe inflammation of the gallbladder.
  2. Experiencing difficulties during an attempted laparoscopic surgery.
  3. Having severe cardiac and respiratory issues.
  4. Having a late term pregnancy.
  5. Experiencing major scarring from a previous surgery.
  6. Having suspected gallbladder cancer, a very rare condition.

Open surgery is just as effective as laparoscopic surgery, but it does have a longer recovery time and causes more visible scarring.

ENDOSCOPIC RETROGRADE CHOLANGIO-PANCREATOGRAPHY (ERCP)

Endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure that can be used to remove gallstones from the bile duct.

Obesity & rapid weight loss post bariatric surgery & risk for gallstones? 

People who are overweight or planning to lose weight –either through a planned diet program or a surgery—have increased risk of developing gallstones. 

People who are overweight may have diets that are high in cholesterol. Your bile has cholesterol in it already, but if your diet has excessive amounts of cholesterol, there is a higher chance it will collect & precipitate in your bile and create a cholesterol gallstone.

  1. Rapid weight loss is also a concern.  If you go on a diet plan that significantly reduces your calorie intake or you have a weight loss surgery, your liver secretes extra cholesterol into the bile. Patients who are undergoing sleeve gastrectomy or  gastric bypass or other weight loss surgical procedures that will lead to rapid weight loss are at risk of gallstone formation.

SURGICAL PACKAGES AVAILABLE

**Insurance companies usually covers this procedure  

Otherwise 25,000- 35,000 AED. depending upon case

Gall bladder surgery (lap cholecystectomy): nowadays a laparoscopic gall bladder surgery that is minimally invasive  and is also the most safest technique, with quick recovery and less post-operative pain.

Check what all is included and not included in the package.

Package includes

  1. Pre-Operative Anaesthesia consultation, blood and other investigations.
  2. Fee of Surgeon.
  3. Operation charges
  4. Doctor Consultation charges
  5. Medication used during and post procedure
  6. Routine laboratory testing.
  7. Post operation Laboratory investigations.
  8. Routine Medical consumables

Package excludes

  1. Any type of therapy, investigation or procedures apart from the above mentioned will be charged separately.
  2. After Discharge medication will be charged separately.
  3. Gall Bladder Surgery Cost

**Insurance companies usually covers this procedure  Otherwise 25,000- 35,000 AED. depending upon case