Gallbladder (Biliary) Surgery [return
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Most of us know of a relative or friend who has undergone
gallbladder surgery. This type of surgery is one of the most common
The gallbladder is a sac-like organ located under the liver on
the right-hand side of your body, just under the rib cage. The liver
performs many tasks in the body, one of which is to produce bile.
Bile is a yellow-green thick liquid which is stored in the gallbladder
via a duct system. Bile assists in the digestion of fatty foods.
After a high fat meal such as fried chicken, butter or ice cream,
your body tells the gallbladder to contract and squeeze out bile
through the ducts into our digestive tract.
"Cholelithiasis" or gallstones can sometimes form. It
is estimated that 12 million Americans have stones in their gallbladder.
A majority of people are not even aware that they have them, but
5-10% will manifest symptoms. Their symptoms can vary from very
mild to severe - even life threatening.
"Biliary colic" is a term used to designate a mild early
symptom. Pain occurs when the stones block the gallbladder's ductal
system. One experiences a feeling of pain or pressure and sometimes
nausea after eating, it tends to subside spontaneously. The pain
occurs when the gallbladder contracts in response to a fatty meal
; pressure builds up secondary to the duct obstruction.
"Acute cholecystitis" is the next level of severity of
gallbladder disease .this term describes symptoms of pain associated
with fever and infection.
"Chronic cholecystitis" describes a condition of long
term history of pain on the rt side of the abdomen and is due to
recurrent bouts of biliary colic or acute cholecystitis with associated
scarring of the gallbladder.
Each of these conditions are best treated by surgery called "cholecystectomy"
which means removal of the gallbladder. The first cholecystectomy
was performed over 100 years ago. For the past 10-15 years, laparoscopic
surgery or removal of the gallbladder though a small incision, has
been performed, shortening the recovery time significantly.
If you have a history of abdominal pain after eating, this may
be due to gallbladder disease. However the pain may also be secondary
to stomach ulcers, gastritis or even heart disease. You should see
your family doctor and/or surgeon for an evaluation.
Biliary surgery-part ii
So far, we have discussed a number of diseases associated with
the gallbladder. Those diseases were associated with gallstones
and included biliary colic, acute cholecystitis, and chronic cholecystitis.
"Choledocholithiasis" is a term used to describe gallstones
that pass from the gallbladder and enter the main bile duct system.
This occurs in 10% of people with gallstones. Symptoms of pain and
fever similar to those of gallstones can occur, but a classic sign
is that of "jaundice". This is when the main bile duct
system is blocked and causes a back-up of bile produced by the liver.
This manifests as a yellow appearance to the skin, the eyes and
associated itching. In this instance, the stone needs to be removed
along with the gallbladder, usually with the help of a gastroenterologist.
"Gallstone pancreatitis" is a condition when a bile duct
stone described above irritates the pancreas whose ducts are connected
to the bile duct system. These symptoms present as a more central
pain, sometimes felt in the patient's back. Treatment is initially
conservative until the pancreatitis is resolved, then the gallbladder
can be removed.
"Cholangitis" is a condition in which a duct blockage
due to a stone is associated with infection. The triad of symptoms
are pain, fever, and jaundice. Treatment is antibiotics and intravenous
fluids, but most importantly, but most importantly, removal of the
stone and decompression of the bile duct system.
Each of these above conditions is listed in order of increasing
severity. Early diagnosis and early treatment increases the chance
of a healthy recovery. All of these conditions can be treated by
laparoscopic techniques, but sometimes a conventional, open operation
If you manifest any of these symptoms, consult your family doctor
for an evaluation.
-- Michael D. Bono, M.D.