Laparoscopic cholecystectomy in Turkey

Laparoscopic cholecystectomy

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 that collects and stores bile (a liquid produced by the liver that helps digest fats) and increases 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.

The gallbladder receives its secretions into the bile duct and then travels to the common bile duct that drains into the duodenum
An image that includes an anatomic overview of the gallbladder and bile ducts

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.

Gallstones form in the gallbladder and then accumulate in the bile ducts and block it
A picture showing the mechanism of blockage of the bile ducts with gallstones

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
  • cholecystitis
  • Formation of gall bladder polyps
  • Pancreatitis due to gallstones
  • cancer Gallbladder

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.

cholecystectomy

In Turkey, there are two ways to perform cholecystectomy:

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.

Note the large incision in the open cholecystectomy
Picture showing open cholecystectomy

Laparoscopic (laparoscopic) gallbladder surgery laparoscopic cholecystectomyIn which the surgeon makes four small incisions, each of which is less than 2.5 cm (less than one inch) long, 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 to facilitate vision, where the surgeon performs this operation while looking at the monitoring screen, and then the gallbladder is removed through one of these incisions. This process also takes an hour or two.

Note the small surgical incisions in laparoscopic cholecystectomy
Image showing laparoscopic (laparoscopic) cholecystectomy

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:

  • bleeding
  • 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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Common Questions

Cholecystectomy is indicated for cholelithiasis, biliary obstruction, and cholecystitis or pancreatitis.

The duration Laparoscopic cholecystectomy is one to two hours.

In the case of laparoscopic excision, the patient returns home the same day and recovers completely after a week.
In the case of open surgery, the patient returns home after 2-3 days and recovers completely after 4-6 weeks.

The human liver adapts to the situation and produces enough bile to digest the fat, but instead of storing it in the gallbladder it will be excreted directly into the digestive system.

There may be risks and pain as a result of this procedure, but these risks are rare and the pain is minimal, and all patients feel much better after removing the gallbladder, and not performing the operation may cause serious problems that may end in death.

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