What Changes in Our Lives After Gallbladder Surgery?
What is bile?
Bile is a liquid composed of several components produced in the liver. Bile is involved in the discharge of various residues from our bodies and digestion. The Liver is the most important laboratory of our body and one of the most important auxiliary elements in producing bile and regulating the ratio of the components that make up the content of bile according to the needs.
What Is Gallbladder?
It will better to understand the gallbladder and bile ducts together. The produced bile begins its journey through the smallest bile ducts in the liver. These small bile ducts in the liver band together and form larger bile ducts, eventually forming the main bile ducts. The place where the journey of bile ends and its mission begins is the duodena, which is the continuation of the stomach. The bile ducts, along with the pancreatic duct, open to the duodena and undertake important roles in digestion. The waste it contains has also reached the intestine and started to be discharged from the body.
The gallbladder is a water drop-shaped sac located directly adjacent to the liver. Its mission is never, ever to produce bile. The gallbladder collects the excess bile produced by the liver when there is no food intake and shrinks and sends the bile to the bile ducts and then to the duodena during a meal.
What are the diseases of the gallbladder and its ducts?
The most types of diseases are inflammation due to stone, obstruction of the bile ducts (blockage jaundice) and inflammation of the pancreas (pancreatitis). Unfortunately, gallbladder and bile duct cancers are also very serious diseases that can occur. This types of cancer with a wide range of diseases should be examined separately, therefore, we will focus more on gallstones and their treatment in this article.
What Are Gallstones?
Gallstones are stone-like formations that occur after the deposition and hardening of the bile inside the gallbladder. They consist of bile components and they can contain different component ratios. The stones can sometimes be as small pebbles or form like sand crystals, and sometimes they can reach the size of an egg. How they form is still unknown. The most commonly discussed opinions are that the bile fluid is prone to deposition or that deposition occurs as a result of insufficient discharge of the gallbladder. The frequency of gallstones increases in women, obesity, rapid weight loss, diabetes and as age progresses.
Do Gallstones Cause Complaints?
Gallstones can cause pain, especially in the upper middle part of the abdomen. This pain usually spreads to the back and shoulder and can be aggravated after meals. Indigestion and abdominal swelling can be considered as other important complaints. It can lead to indigestion, which can lead to nausea and vomiting. As can be seen, it can lead to very generic complaints that can be confused with other diseases. These complaints may be caused either by gallstones or other abdominal organs. When these complaints occur, it is especially necessary to refer to the doctor to prevent harmful and risky situations that may occur in the future.
What Are the Risks of Having Gallstones?
Gallstones, apart from the complaints we mentioned, can cause inflammation of the gallbladder (acute cholecystitis), jaundice (obstruction or inflammation of the bile ducts), or inflammation of the pancreas (acute pancreatitis). These conditions are manifested by severe abdominal pain, fever, nausea, vomiting and sometimes yellowing of the skin. What triggers these diseases or when do they occur is unknown. The truth revealed is that the longer the years are lived with gallstones, the more likely they are to occur. Another important fact is that once these diseases are diagnosed, they are more likely to relapse with a more severe course. Another important predictor of these diseases is the severity of the disease, while it can be overcome with very mild outpatient treatment, it can also lead to life-threatening risky situations. Gallbladder cancers are also more likely to occur in people with gallstones.
How Are Gallstones Diagnosed?
The diagnosis can be made either by the tests or with the complaints mentioned, or with examinations made for other reasons. The most common examination of the diagnosis is made with the ultrasound examination of the abdominal region. With ultrasound, the size of the wall of the gallbladder, the presence of stones in it and even the condition of the bile ducts can be examined with high accuracy. In a variety of cases, CT and MRI assistance may be required.
How Are Gallstones Treated?
The treatment of gallstones depends on the anatomical location and the condition caused by it. It is not possible to get rid of gallstones permanently with medication.
This procedure is called cholecystectomy and it can be done with open or closed methods. The closed method is the laparoscopic method, a form of abdominal surgery with holes created in the abdominal region without making any incision. What is important in surgery is the safe removal of the entire gallbladder. With the development of various procedures, while the surgery remained the same, advantages were obtained in terms of returning to normal after the surgery, pain and cosmetic (scar) results.
In the closed method, surgery is performed with incision holes in 4 different places into the abdomen or with a single large hole cut in the belly button. Both methods enable the patient a faster return to normal life and less pain after surgery than the open method. The most important advantage of one-hole closed gallbladder surgery (single incision laparoscopic cholecystectomy) is that it is “scarless surgery” thanks to the incision hidden in the navel. The most important warning we give to these patients is that they must remind other physicians that their gallbladder has been removed because there will be no scarring after surgery.
In the presence of stones in the bile ducts along with the gallbladder, stones in the bile ducts should be removed without removal of the gallbladder. Instead of applying surgery to the bile ducts, performing the ERCP procedure, which is a much more comfortable and painless procedure for the patient, may be preferred. In the ERCP procedure, it is possible to remove the stone and to expand the lower end of the bile duct with the help of catheters (small pipes) that are advanced here by finding the mouth of the bile ducts that open to duodena with the endoscope entered through the mouth. After the successful conclusion of this procedure, the gallbladder must be removed and the source of the disease should be eliminated and relapse of disease should be prevented. In some cases, the stone in the bile ducts may not be removed by ERCP or similar procedures. These conditions require more severe and complex surgical procedures, although few are encountered.
In the case of gallbladder inflammation and if the general condition of the patient is suitable for surgery and early stage, the first option is to remove the gallbladder with closed procedure. However, these emergency operations are more likely to change from closed to open surgery. Inflammation of the gallbladder or bile ducts and the pancreas can lead to life-threatening diseases that may require different surgical procedures. Age progression and the presence of accompanying diseases even increase these risks. Relapsing inflammation complicates surgical anatomy, increasing the chance to switch from laparoscopic surgery to open surgery. The risks associated with surgery are known to increase in these cases.
Does Gallbladder Surgery Have Risks?
Gallbladder surgery (cholecystectomy) is a procedure performed by thousands of people every year. After this surgery, unwanted side effects such as wound site infection, embolism, lung infection can be seen at very low rates. Specific to this kind of operation, there is a risk of injury to the bile ducts or the main vessels of the liver. It is important to note that these unwanted side effects are relatively likely to occur during and after inflammation.
What Changes in Our Lives After Gallbladder Surgery?
The gallbladder is not an absolute necessary organ for digestion. After the removal of the gallbladder, the bile continues to flow from the liver to the intestine. Therefore, a normal balanced diet can be followed after surgery. There are no nutritional restrictions. In other words, there are no foods to avoid eating after the removal of gallbladder. Although rare, it is seen that a group of patients reporting indigestion after surgery, however, this is not the case for the vast majority of patients. Even when nutrition-related complaints and quality of life were examined, it was observed that there was a very high rate of improvement after surgery compared to before.