Gallbladder Problems

If the stones in the gallbladder cause repeated attacks of pain, despite changes in diet the doctor may advise the removal of the gallbladder (Cholecystectomy). The removal of the gallbladder bladder does not cause nutritional deficiency and no restrictions are required diet after surgery. Between 1 and 5 per 1000 patients treated with this procedure, die. During the cholecystectomy, the physician will investigate the possibility of bile duct stones.

Laparoscopic cholecystectomy was introduced in 1990 and in a few years revolutionized surgical practice. 90 percent of cholecystectomies is now performed laparoscopically. In cholecystectomy laparoscopic gallbladder is removed with support tubes that are inserted through small incisions in the abdominal wall. The entire procedure takes out with the aid of a camera (laparoscope), which also is introduced into the abdomen through the incision. Cholecystectomy Laparoscopic have lower postoperative discomfort, less hospital stay and require a short period of absence from work due to illness.

Other methods of removing gallstones introduced during the last decade include your solution with ether and  fragmentation with shock sound waves (lithotripsy). Treatment oldest meant the dissolution of the calculations with chronic biliary bile acid therapy (chenodiol ursodeoxycholic acid).

Bile Ducts Calculations

Stones in the bile ducts may cause serious gallbladder problems, so it should be removed with surgery abdominal or through a procedure called cholangiopancreatography endoscopic retrograde (ERCP). In ERCP, an endoscope (Flexible optical tube equipped with surgical attachments) is passed through the mouth, esophagus, stomach and intestine intestine. A radiopaque substance is introduced into the bile duct through the tube in the sphincter of Oddi. Then performing a procedure called a sphincterotomy, by which opens the sphincter muscle enough for the calculations that were obstructing the bile duct can pass into the small intestine. ERCP and sphincterotomy completely successful in 90 percent of cases. Less 4 out of 100 people die and between 3 and 7 100 people manifest complications, therefore, these procedures a safer option than abdominal surgery. Among the immediate complications that can occur are bleeding, inflammation of the pancreas (pancreatitis) and perforation or infection of the bile ducts. In a 2 to 6 percent of the people, the ducts are narrowed again and gallstones recur. Calculations they are only located in the gallbladder can not be removed with ERCP.

ERCP gives better results in older advanced bile duct stones and gallbladder bile duct removed in these cases, the success rate is comparable to abdominal surgery. In most of elderly patients who have never had  gallbladder problems removal thereof shall unnecessary because only 5 percent have symptoms Repeated bile duct stones.

In patients younger than 60 years with problems derivatives of bile duct stones or gall, they should remove the gallbladder as scheduled after having undergone ERCP with sphincterotomy. Otherwise, run the risk of developing acute gallbladder in the future. Most duct stones bladder can be removed during ERCP. If some in the canal is often achieved later pass through the sphincterotomy permanent. If one is not removed, can be removed endoscopically before removing the drainage has been introduced in the duct bladder during surgery.

Acute Cholecystitis

Cholecystitis is an inflammation of the gallbladder wall, usually the result of a calculation in the cystic duct, which causes sudden onset of pain and very sharp.

At least 95 percent of individuals with acute inflammation of the gallbladder have stones bile. In rare cases, inflammation is caused by infection bacteria.

Acute inflammation of the gallbladder without the presence of bladder stones is a serious disease. Tends to occur after injuries, operations, burns, widespread infection throughout the body (sepsis) and critical illness, particularly in patients receiving prolonged feeding intravenously. The person does not usually show symptoms previous disease of the gallbladder until it undergoes sudden and excruciating pain in the upper abdomen. In general, the gallbladder diseases are very serious and can forecast lead to gangrene or perforation of the gallbladder. Immediate surgery is needed to remove the gallbladder.

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