Gallbladder Problems

Female, fat, and forty … often describes the typical gallbladder patient. However, gallbladder disease can strike almost anyone, although overweight women over forty, overweight and inactive men, and the elderly are particularly at risk. Gallbladder problems usually begin with the formation of gallstones (cholelithiasis). Gallstones form from an abnormal amount of salts in the bile that gallbladders secrete to help digestion. Eventually they block the bile duct and inflame the gallbladder, causing much pain and requiring prompt medical attention with either medication or surgery.

Nationwide, more than 500,000 people each year have their gallbladder surgically removed in a procedure called cholecystectomy. After such surgery, these patients experience considerable discomfort and undergo a lengthy period of recovery. The resultant cost in health care dollars is enormous. As a result of all these factors, alternative treatments for gall bladder disease have been sought.

The most successful and cost-effective solution seems to be a new surgical technique called endo-cholecystectomy. Endo- cholecystectomy is a surgical procedure which uses probes, a tiny camera, and a laser device inserted through the navel to remove the gallbladder. To perform the operation,  doctors make four punctures in the abdomen, inflate the cavity with gas to give them room to maneuver, and then insert tubes with forceps and other tools at their ends. A laparoscope, or camera-type device is inserted and transmits an image of the abdominal cavity onto a video screen allowing the surgeons to see what they are doing. A tube-shaped laser device does all the cutting and cauterizing.

This entire procedure can be done in as little as an hour. The advantages of endo-cholecystectomy are immediately apparent—both the hospital stay and the postoperative recovery period are greatly reduced with this technique. Approximately 15%-20% of patients who undergo endo-cholecystectomy are discharged on the day of surgery; the other two-thirds are hospitalized for only one night. The majority of patients are able to return to full activity within three to five days. By contrast, patients who undergo routine cholecystectomy (traditional gallbladder surgery) require three to seven days in the hospital and a three to six week recovery period. In addition, patient discomfort and disfigurement are dramatically reduced following endo-cholecystectomy.

Camera probes and laser devices are not new in the held of medicine; they have been used in the field of gynecology for the past 20 years. Soon they may be applied to appendectomies and other abdominal- cavity surgery. Local doctors predict that in the next few years almost all Bay area hospitals will be offering this type of surgical technique. During the past two decades incredible studies have been made in many fields of medicine.

New medications have been developed which eliminate symptoms and relieve suffering. New modalities, such as mammography and sonography, are making the early diagnosis of many diseases, including cancer, possible. And now, with new surgical techniques, such as endo-cholecystecomy, surgery is becoming less painful and traumatic for the patient, as well as more cost-effective for all those involved with health care delivery. Throughout the next decade, we will be seeing amazing advances in the field of medicine that we can barely imagine now.

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