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Gallbladder & Laparoscopic Surgery
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A significant
breakthrough in the surgical procedure of removing the gallbladder, was the
development of the
laparoscopic
cholecystectomy. This is probably one of the greatest advances that has occurred
in general surgery over the past two decades.
Since its inception
15 years ago, Dr. Smith has been involved in
well over 2,000
laparoscopic general
surgical procedures.
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Dr. Smith
performing Laparoscopic Surgery
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The gallbladder
is a small pear shaped organ located beneath the right lobe of the patient’s
liver. It serves as a storage depot for bile that is produced in the liver. For some reason as
yet to be determined, some patient’s gallbladders will
form gallstones from the bile that is stored there. A gallstone can be as big as
a grain of sand or as big as a golf ball. The patient may have one single stone
or hundreds of stones and they can cause similar problems and complications.
Symptoms of gallbladder disease can be very mild ranging from simple nausea,
upset stomachs, bloating, or indigestion; to rather severe symptoms that will
have the patient in the emergency room in the middle of the night to seek pain
relief. In the vast majority of cases,
cholecystectomy, the
removal of the gallbladder, can be done through the laparoscope as an outpatient
procedure. Usually patients are able to return to normal activities within three
to seven days of the surgical procedure. Approximately 10-15% |
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of patients
will have “acalculus cholecystitis”. This is a condition where the patient has
symptoms and signs of gallbladder disease but does not actually have gallstones.
The condition is usually diagnosed by having a HIDA scan with an ejection
fraction performed. In most patients with acalculus cholecystitis the ejection
fraction will be less than 35%. Again, as in gallbladder disease associated with
stones, the treatment for this condition is cholecystectomy. Benign polyps of
the gallbladder are small mushroom shaped growths that can occur inside of the
gallbladder. The exact etiology of these polyps is not known. The polyps can
cause typical gallbladder symptoms in some patients and in others they may be
entirely asymptomatic. Controversy exists among the surgical community as to
whether gallbladder polyps will increase a patient’s risk of developing
gallbladder cancer. Generally in an otherwise healthy patient, cholecystectomy
is recommended for significant gallbladder polyps.
In general, a patient will be much better off approaching his gallbladder
problems on an elective basis so that he will be able to have laparoscopic
surgery performed, rather than waiting until the gallbladder becomes severely
diseased which may require emergency surgery that may result in an open or
classical cholecystectomy. The open or classical cholecystectomy will
hospitalize the patient for three to five days and slow them down for four to
six weeks after leaving the hospital.
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The laparoscopic technique of
gallbladder removal will allow the patient to resume his normal activities much
quicker and with much less pain and discomfort than open surgical procedures. |
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The development of
laparoscopic cholecystectomy is probably one
of the greatest advances that have occurred in General Surgery over the past two
decades. Dr. Smith has extensive experience in laparoscopic cholecystectomy. The vast majority of
laparoscopic cholecystectomies are done on an outpatient basis and allow the
patient to recover in the comfort of his/her own home.
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