a new approach to the Gallbladder Polyps and Gallstone Treatment
Gallbladder Preserving Surgery
Gallbladder Preserving Surgery
Is the Gallbladder a vital organ?
Of course every organ in our body is important and all the systems are in interaction with each other. Any dysfunction or deficiency of an organ affects the other organ and the systems negatively. The gallbladder is also a very important organ for the digestive system.
The gallbladder has these functions which are vital for the digestive system and our biological clock; storage, concentration and when required excretion processes of the bile. By means of the gallbladder it’s possible that the bile flows into intestines intensively only in digestion period of the food. Infact the bile is a detrimental agent for our digestion cells. The existence of the gallbladder saves our digestion cells by preventing them from continuously being exposed to bile. Besides it provides our digestive system to rest by hanging the bile on in the period of the night sleep in which we stay hungry for a long time.When fatty foods reach the small intestine, the gallbladder excretes the bile to the intestine by straining. The bile cuts the fats into very small pieces by the detergent like affect. By these means fats and fat soluble vitamins are easily dispersed into the body being absorbed by small intestinal cells. This cycle is destroyed in people who had their gallbladder taken A more fluid (having lower density) bile flows into intestines continuously. When stomach and the intestines are constantly exposed to the bile and the bile salts, it causes alkaline reflux gastritis( indigestion, swelling, reflux )or inflammation in the intestine (swelling, diarrhea). Due to the fact that the density of the bile is low, the fats cannot splinter and be digested effectively.
As a result of this situation, %40 of people who had their gall taken, have digestive complaints like indigestion to fatty foods, stomach ache, swelling, diarrhea or oily defecation.
Is it possible to take the gallstones without taking the gallbladder? Which patients are suitable for this operation?
The gallbladder coordinates with all the organs and all the systems in our body; especially with the digestive system. Any disorder in other systems affects the gallbladder. The disorders occurring in the digestive system due to the malnutrition or our body being exposed to toxins causes chronical inflammation and functional disorder in the gallbladder as it happens in all systems. As a result of chronic inflammation the cholesterol, the bile acid and the liver metabolism are influenced and cause gallstones in the gallbladder and chronic inflammation. It also occurs other systematical disorders in high level in the patients who have the gallstones in their gallbladder. It is not a right approach to charge only the gallbladder for the existence of the gallstone.
The principle must be to save the organ.
That’s why if there’s no emergency to take the gallbladder, for the patiens who have the properties below, just the gallstone can be taken by saving the gallbladder. The medical precautions for the gallbladder and the other system disorders should be apllied before the operation and proceed after the operation.
*Patients not having the gallbladder inflammation or cholecystitis attack
*Patients not having the gallstone story in their families’ several members
*Patients not having ERCP in their main bile duct
*Patients not having the cancer suspecion
*Patients not having accompanying check up or tough chronic disease(obesity, diabetes, heart disease or liver failure ect.)
*Patients not having an operation of hypochondrium
*Patients having the normal gallbladder function and wall thickness in ultrasonography
*Patients having less than 3 gallstones are suitable for the preserving surgery
How are the patients prepared for the gallbladder preserving surgery?
By an elaborate examination and medical work up, existing systematic disorders (stomach and intestinal system, hormonal system, neurological system) are determined.
By means of the ultrasonography, the structural features and the functions of the gallbladder are evaluated. The number of the stones are detected. The diet and the life styles of the patients decided suitable for the operation should be arranged.
The vitamins and minerals lacking in the body should be replaced. The patients should be watched carefully, until the disordered systems and organs heal. When the precautions succeed, the gallstone removing surgery can be arranged by evaluating the functions of the gallbladder. The preoperative period is organised according to the medical condition of the patient.
How is the gallbladder preserving surgery done?
The gallstone removing surgery is done under general anaesthesia, by means of the tiny holes opened from the abdominal wall with laparoscopic surgery.
The number of the orifices opened from the abdominal can vary according to the situation of the gall bladder. Usually two holes are enough. During the operation camera systems and special laparoscopic tools are used. The small cut is done from the top of the gallbladder. The stones are taken by getting into the gallbladder with the camera. Also when a polyp is detected in the gallbladder, the polyp can be taken out with the same process and the pathological examination can be done during the operation. When it is ensured that there is no gallstone left in the gallbladder and in the gallbladder duct, mucosa and serosa layers are closed by sutures which are absorbed separately. The orifices in the abdominal wall are closed by stitching,too.
What are the complications of the gallbladder preserving surgery?
The ratio of the complications of the gallbladder preserving surgery is lower than the ratio of the gallbladder removal (Cholecystectomy). Some complications can occur due to the general anesthesia. After the gallstone is taken out, the orifice opened to the gall blader is closed by stiching. In the cases around the world no bile leakage was obsesrved from this stiching point. However there is a possibility like this. In a situation like this, the gallbladder must be taken out. Rarely there could be a risk of stone falling into the main bile duct. Some complications like wound infection, bleeding and hernia can seldom occur.
What is the risk of recurring of gallstones after being taken out?
Recurrence of the gallstones in the pursuits from one month to ten years is between %5-30. Due to attentive patient selection, following nutrition and support advices pre and postoperative, the recurrence of the gallstones will decrease. When recurrence arises, it can cause some problems that we have referred to in the part ‘What kind of disorders could the gall stones cause?’. In the researches it is declared that the recurring stones are mostly asymptomatic (not causing complications) stones. In the event of complication, the cure is to take the gall blader out.
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