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   Gallbladder & Laparoscopic Surgery

 

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. 

Dr. Smith performing Laparoscopic Surgery

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%
 

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.  


 





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.

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. [top]

 

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