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OF THE MEDICAL REPORT
Alicia Kieninger , MD
St. Joseph Mercy Oakland
General Surgery
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THE FACTS ABOUT Laparoscopic Gallbladder Surgery

Background

Gallstones are a common problem affecting hundreds of
thousands of people in the United States annually. Approximately
10-20 percent of the population will develop gallstones at some
point in their life. Eighty percent of these people will never
develop symptoms related to their gallstones. However, with a
complication rate of 1-2 percent annually, surgery is indicated once
symptoms develop.
 

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Surgery to remove the gallbladder is one of the most common
procedures performed by general surgeons in this country, with
over 500,000 procedures performed annually. Understanding the
signs and symptoms of gallstone disease can help many individuals
recognize this common problem and seek treatment prior to the
development of more significant complications.





The purpose of the gallbladder is to store bile made by the
liver for release during meal times to aid in the digestion of
fats. Gallstones form when an imbalance occurs in the normal
composition of bile, causing crystallization of the bile into stones.


SYMPTOMS
Symptoms occur when a stone blocks the flow of bile from the Arterial disease can also manifest itself as aneurysms. Whereas
restrictions of blood flow may result in pain, the breakdown
of the wall of an artery results in a weakness that may then
become an aneurysm, or ballooning of the artery, a condition
that usually has no symptoms. Often associated with potential
for rupture and death, aneurysms may produce other
complications. Recent advancements allow us to treat these
aneurysms with minimally invasive techniques, but every patient
should discuss all of their options with a specialist, to ensure
the most appropriate treatment

EVALUATION AND TREATMENT
Evaluation for gallstone disease should include an ultrasound of
the abdomen, focusing on the right upper quadrant. Ultrasound
remains the best radiologic test to evaluate for gallstones. The
ability to detect gallstones on plain X-rays and CT scans is very
limited. Once symptoms develop and the presence of gallstones
is confirmed by ultrasound, elective surgical removal of the
gallbladder (cholecystectomy) is indicated.


The surgical treatment of gallstones has evolved significantly
over the last 15-20 years. With the advent of laparoscopy, the
gallbladder can be removed on an outpatient basis with rapid
return to usual activities. In the past, open cholecystectomy
required a several day hospitalization for pain control, as well
as many weeks of limited activity in order to allow the larger
incision to heal. Laparoscopic cholecystectomy now has an
excellent safety profile with a very low complication rate.


CAUTIONS
Left untreated, symptomatic gallstones can lead to more
significant complications. The most common of these is acute
cholecystitis, a more significant inflammation and infection
of the gallbladder. Gallstones can also cause pancreatitis, or
inflammation of the pancreas, as well as jaundice (yellowing of
the skin), if stones escape the bile duct and cause a blockage
of the main bile duct and pancreatic duct. Unfortunately,
medical treatments aimed at preventing or dissolving gallstones
are of limited success, and can be very expensive. For these
reasons, once symptoms of gallstones are identified, surgery
is recommended to treat the symptoms and prevent further
complications.

PHYSICIAN REFERRAL
For referral to a St. Joe general surgeon, call the hospital’s
referral line at 800-372-6094.
 

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