The formation of painful gallstones is a common and serious problem if not treated, you can now perform laparoscopic cholecystectomy in Turkey and prevent these stones from forming again and return to your home the same day.
A glimpse of the gallbladder
The gallbladder is a small, pear-shaped organ located under the liver in the upper right quadrant of the abdomen. It performs the function of collecting and storing bile (a liquid produced by the liver that helps digest fats) and increasing its concentration.
When the fat-containing food reaches the small intestine, the gallbladder contracts and secretes bile into the small intestine through the bile ducts.
Changes in the composition and concentration of bile stored in the gallbladder due to hormones, medications, rapid changes in weight or diet may lead to the formation of solid masses of bile called gallstones.
Cholelithiasis is very common and may be associated with intermittent abdominal pain, nausea and vomiting, usually after eating.
The risk of gallstone formation increases in women, especially those who have given birth to children, obese people, and people over the age of 40, and when there is a family history of cholelithiasis.
Gallstones formed in the gallbladder can pass out into the bile ducts and block the normal flow of bile, leading to cholestasis that manifests as severe abdominal pain, nausea, vomiting, indigestion, fever and jaundice (yellow color of the skin) of the obstructive type. This stasis predisposes to cholecystitis and infection.
Cholecystitis presents with persistent acute abdominal pain, fever, nausea and vomiting, which necessitates a visit to the doctor who performs an ultrasound to confirm the diagnosis and refer the patient to surgery when needed.
If these gallstones stop at the level of the collecting duct and block it, the flow of pancreatic juices also stops and the digestive pancreatic enzymes are activated inside the pancreas, which results in pancreatitis, in addition to the symptoms of cholestasis mentioned previously.
Reasons for gallbladder removal
Gallstones may not need treatment if they are small and not causing problems.
Cholecystectomy is indicated in one of the following cases:
- gallstones (many stones of different shapes and sizes form inside the gallbladder)
- Presence of gallstones in the bile ducts
- Formation of gall bladder polyps
- Pancreatitis due to gallstones
- Gallbladder cancer
In a few cases, pills to dissolve gallstones are indicated, but they have not been proven effective in treating gallstones, making cholecystectomy the best treatment in most cases.
Gallbladder removal surgery
In Turkey, there are two ways to perform cholecystectomy surgery:
Open cholecystectomyIn which the surgeon opens the abdomen and removes the gallbladder through a 12.5-17.5 cm incision on the right side under the ribs so that the surgeon can see the gallbladder and separate it from the neighboring organs. Two hours.
Laparoscopic (laparoscopic) gallbladder surgery laparoscopic cholecystectomyIn it, the surgeon makes four small incisions, each less than 2.5 cm long (less than one inch), to insert a long, thin tube equipped with a precise camera and surgical tools called a laparoscope. Carbon dioxide may be pumped through these incisions into the abdominal cavity to inflate the surgical area. And facilitating vision, as the surgeon performs this operation while looking at the monitor screen, then the gallbladder is removed through one of these incisions. This process takes an hour or two as well.
The previous two operations are performed under general anesthesia, meaning that the patient is asleep during the operation and does not feel any pain during its implementation.
Cholecystectomy side effects
Cholecystectomy carries a risk of complications, including:
- Infection and the occurrence of peritonitis
- Injury to the bile duct that carries bile from the gallbladder to the small intestine
- Liver damage
- Surgical scars and numbness at the site of the incision
- A hernia at the surgical site
- Small bowel perforation in laparoscopic cholecystectomy
- Side effects of general anesthesia such as clot formation and pneumonia
- Inflammation of the urinary tract
Most of these complications are rare, meaning they almost never occur.
Benefits of gallbladder removal
Removing the gallbladder will relieve the pain, treat the inflammation caused by the gallstones, and prevent them from forming again.
If cholelithiasis is not treated, the pain and infection will worsen, and the gallbladder may rupture and threaten the patient's life.
Advantages of laparoscopic cholecystectomy
Laparoscopic cholecystectomy has many advantages that make it better than open cholecystectomy, including:
- less painful
- Less risk of complications
- Healing and returning to daily activities faster
- Smaller incisions and therefore smaller surgical scars
It has shown many studies Its effectiveness when selecting the right patients for this procedure.
As laparoscopic cholecystectomy is not suitable for all people, after starting laparoscopic surgery, we may have to transfer the patient to open surgery.
Some cases that require open surgery or referral to it:
- The patient's gallbladder is severely damaged due to scarring or inflammation
- The patient's abdomen contains surgical scars from previous surgeries
- obesity severe
- The surgeon cannot see well inside the patient's abdomen with the endoscope
- If the patient has bleeding problems during surgery
Switching to open surgery is not a problem for the patient, the surgeon will decide the optimal and safest treatment option for cholecystectomy.
Life after cholecystectomy
A person can live a normal life after gallbladder removal, where the liver adapts to the condition and produces enough bile to digest food, but instead of storing it in the gallbladder it will be excreted directly in the digestive system.
Patients who undergo laparoscopic cholecystectomy often go home the same day of the procedure or have an overnight stay in the hospital, and full recovery takes about a week.
Patients undergoing open cholecystectomy need to spend two to three days in the hospital, and full recovery takes 4-6 weeks.
Patients can return to eating normally upon returning home.
It is common for the patient to feel mild to moderate pain at the site of the operation during several days after the surgery, which is managed with pain relievers.
The dressings can be removed the day after surgery, allowing the patient to return to showering normally (some wounds may need special care).
Some people may experience diarrhea after a cholecystectomy that usually goes away on its own after a few weeks or months.
Tips after gallbladder removal
After a cholecystectomy, there are some tips that help the patient recover faster, including:
- Avoid carrying heavy items
- Make sure to drink an adequate amount of water daily
- Eat foods rich in fiber to help have a bowel movement
- Follow your doctor's advice for wound care and medication
- Gradually increase daily activities
- Walking short distances daily helps prevent clots
The patient should contact his doctor if he encounters any of the following problems after cholecystectomy:
- a fever over 38.5°C (101°F)
- Severe pain that does not respond to analgesics or swelling at the surgical site
- jaundice (yellow color to the skin)
- Inability to eat and drink due to nausea and vomiting
- Bleeding or oozing from the operation site
- Respiratory problems or a cough that does not improve on its own
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