Gall Stones Treatment is discussed and major issues pertaining to Gall Stone is discussed herewith.
Q. What is Gallbladder? What is the function of it?
Gall bladder is a pear shaped pouch which is located under the liver. Its primary function is to store and concentrate bile. Gall bladder also secretes mucus .The gallbladder serves as a reservoir for bile while it’s not being used for digestion. The bile helps the digestive process by breaking up fats. It also drains waste products from the liver into the duodenum, a part of the small intestine.
Q. What are Gall Stones and What are the types of Gall Stones?
Gallstones are generally small, hard deposits inside the gallbladder that are generally formed when stored bile crystallizes. Gallstones range in size. They can be as small as a grain of sand or as large as an apricot.
The three most common types of gall stones are:
- Cholesterol gallstones
- Pigment gallstones
- Mixed stones
Cholesterol gallstones are associated with female sex. Other risk factors include the following:
• Gallbladder stasis
Cholesterol gallstones are more common in women who have experienced multiple pregnancies. A major contributing factor is thought to be the high progesterone levels of pregnancy.
Other causes of gallbladder stasis associated with increased risk of gallstones include high spinal cord injuries, prolonged fasting with total parenteral nutrition, and rapid weight loss associated with severe caloric and fat restriction (eg, diet, gastric bypass surgery).
A number of medications are associated with the formation of cholesterol gallstones. Estrogens administered for contraception or for the treatment of prostate cancer increase the risk of cholesterol.
Clofibrate and other fibrate hypolipidemic drugs increase hepatic elimination of cholesterol via biliary secretion and appear to increase the risk of cholesterol gallstones. Somatostatin analogues appear to predispose to gallstones by decreasing gall bladder emptying.
Black and brown pigment gallstones
Black pigment gallstones occur in individuals with high heme turnover. Disorders of hemolysis associated with pigment gallstones include sickle cell anemia, hereditary spherocytosis, and beta-thalassemia. About half of all cirrhotic patients have pigment gallstones.
Cholesterol gallstones may become colonized with bacteria and can elicit gallbladder mucosal inflammation. Lytic enzymes from the bacteria and leukocytes hydrolyze bilirubin conjugates and fatty acids. As a result, over time, cholesterol stones may accumulate a substantial proportion of calcium bilirubinate and other calcium salts, producing mixed gallstones.
Q. What are the symptoms of gallstones treatment?
Gall Stone Treatment may be thought of as having the following 4 stages:
1. Lithogenic state, in which conditions favour gallstone formation
2. Asymptomatic gallstones
3. Symptomatic gallstones, characterized by episodes of biliary colic
4. Complicated cholelithiasis
Patients with the lithogenic state or asymptomatic gallstones have no abnormal findings on physical examination.
A person with gallstones will rarely feel any symptoms until the gallstones reach a certain size, or if the gallstone obstructs the bile ducts.
But if you do get symptoms, they usually include:
• Pain in your upper belly and upper back that can last for several hours
• Other digestive problems including bloating, indigestion and heartburn, and gas.
The presence of fever, persistent tachycardia, hypotension, or jaundice necessitates a search for complications, which may include the following:
• Acute Cholecystitis
• Gall bladder carcinoma
Complications of Gall Stones Treatment
Acute cholecystitis occurs when persistent stone impaction in the cystic duct causes the gallbladder to become distended and progressively inflamed. Patients experience the pain of biliary colic, but, instead of resolving spontaneously, the pain persists and worsens.
Overgrowth of colonizing bacteria in the gallbladder often occurs, and, in severe cases, accumulation of pus in the gallbladder, termed gallbladder empyema, occurs. The gallbladder wall may become necrotic, resulting in perforation and pericholecystic abscess. Acute cholecystitis is considered a surgical emergency, although pain and inflammation may subside with conservative measures, such as hydration and antibiotics.
The gallbladder wall may become necrotic, resulting in perforation and pericholecystic abscess.
Acute cholecystitis is considered a surgical emergency, although pain and inflammation may subside with conservative measures, such as hydration and antibiotics.
Chronically, gallstones treatment can cause progressive fibrosis of the gallbladder wall and loss of gallbladder function, termed chronic cholecystitis. The pathogenesis of this complication is not completely understood. Repeated attacks of acute cholecystitis may play a role, as may
The pathogenesis of this complication is not completely understood. Repeated attacks of acute cholecystitis may play a role, as may localized ischemia produced by pressure of stones against the gallbladder wall. The chronically fibrotic gallbladder may become shrunken and adherent to the adjacent viscera.
The chronically fibrotic gallbladder may become shrunken and adherent to the adjacent viscera.
Gallbladder adenocarcinoma is an uncommon cancer that usually develops in the setting of gallstones and chronic cholecystitis. Gallbladder cancers commonly invade the adjacent liver and common bile duct, producing jaundice. The prognosis is poor unless the cancer is localized to the gallbladder, in which case cholecystectomy may be curative.
Gallbladder cancers commonly invade the adjacent liver and common bile duct, producing jaundice.
The prognosis is poor unless the cancer is localized to the gallbladder, in which case cholecystectomy may be curative.
Occasionally, a large stone may erode through the wall of the gallbladder into an adjacent viscus (typically the duodenum), producing a cholecystoenteric fistula. The stone, if sufficiently large, may obstruct the small intestine, usually at the level of the ileum, a phenomenon termed gallstone ileus.
Q. Which all tests are needed to be performed for gall stones treatment?
Patients with uncomplicated cholelithiasis or simple biliary colic typically have normal laboratory test results; laboratory studies are generally not necessary unless complications are suspected. Blood tests, when indicated, may include the following:
• Complete blood count (CBC) with differential
• Liver function panel
Ultrasonography – The procedure of choice in suspected gallbladder or biliary disease
Cholecystectomy for asymptomatic gallstones may be indicated in the following patients:
• Those with large (>2 cm) gallstones
• Those who have a nonfunctional or calcified (porcelain) gallbladder on imaging studies and are at high risk of gallbladder carcinoma
• Those with sickle cell anemia
Patients with the following risk factors for complications of gallstones may be offered elective cholecystectomy, even if they have asymptomatic gallstones:
• Portal hypertension
• Transplant candidates
• Diabetes with minor symptoms
Q. If Gall Stones Treatment is not done can it cause gall bladder cancer?
Yes gall stones are associated with higher risk of gall bladder cancer .
Q. What are the consequences and long-term side effects of gallbladder removal under Gall Stones Treatment?
Surgical removal of the gallbladder (cholecystectomy) is the most common way to gall stones treatment. As such there is no side effect following gall bladder removal. The patient is advised to take fat restricted diet for few weeks after surgery after which normal diet is resumed.
Laparoscopic Cholecystectomy is the Gold Standard technique in the management of gall stone treatment.
Q. Can gallstones come back after gallbladder removal?
No once gall bladder is removed completely there is no chance of stone formation.
Q. What is the recovery time afer Gall Stones Treatment?
Following Laparoscopic cholecystectomy patient is discharged the next day, and the patient can resume his/her duty within 2-3 days.
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