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Gall Stone Surgery India

What are Gallstones?

Gallstones are small, pebble-like substances that develop in the gallbladder. The gallbladder is a small, pear-shaped sac located below your liver in the right upper abdomen. Gallstones form when liquid stored in the gallbladder hardens into pieces of stone-like material. The liquid called bile helps the body digest fats. Bile is made in the liver, and then stored in the gallbladder until the body needs it. The gallbladder contracts and pushes the bile into a tube called the common bile duct that carries it to the small intestine, where it helps with digestion.

What is Laparoscopic Gallstone Surgery?

Laparoscopic Gallbladder Surgery is the best method of treating Gallstones that cause symptoms, unless there is a reason that the surgery should not be done. Laparoscopic surgery is used most commonly when no factors are present that may complicate the surgery. Laparoscopic Gallbladder Surgery (Cholecystectomy) removes the gallbladder and Gallstones through several small incisions in the abdomen. The surgeon inflates your abdomen with air or carbon dioxide in order to see clearly.

What are the Causes of Gallstones?

Gallstones occur when bile forms solid particles (stones) in the gallbladder.

• The stones form when the amount of cholesterol or bilirubin in the bile is high. 

• Other substances in the bile may promote the formation of stones. 

• Pigment stones form most often in people with liver disease or blood disease, who have high levels of bilirubin. 

• Poor muscle tone may keep the gallbladder from emptying completely. The presence of residual bile may promote the formation of Gallstones.

Risk factors for the formation of cholesterol Gallstones include the following:

• Female gender, 

• Being overweight,

• Losing a lot of weight quickly on a "crash" or starvation diet, or

• Taking certain medications such as birth control pills or cholesterol lowering drugs.

Gallstones are the most common cause of gallbladder disease.

• As the stones mix with liquid bile, they can block the outflow of bile from the gallbladder. They can also block the outflow of digestive enzymes from the pancreas. 

• If the blockage persists, these organs can become inflamed. Inflammation of the gallbladder is called cholecystitis. Inflammation of the pancreas is called pancreatitis. 

• Contraction of the blocked gallbladder causes increased pressure, swelling, and, at times, infection of the gallbladder.

When the gallbladder or gallbladder ducts become inflamed or infected as the result of stones, the pancreas frequently becomes inflamed too.

• This inflammation can cause destruction of the pancreas, resulting in severe abdominal pain. 

• Untreated gallstone disease can become life-threatening, particularly if the gallbladder becomes infected or if the pancreas becomes severely inflamed.

What are the Symptoms of Gallstones?

As Gallstones move into the bile ducts and create blockage, pressure increases in the gallbladder and one or more symptoms may occur. Symptoms of blocked bile ducts are often called a gallbladder “attack” because they occur suddenly. Gallbladder attacks often follow fatty meals, and they may occur during the night. A typical attack can cause

• Steady pain in the right upper abdomen that increases rapidly and lasts from 30 minutes to several hours

• Pain in the back between the shoulder blades

• Pain under the right shoulder

Notify your doctor if you think you have experienced a gallbladder attack. Although these attacks often pass as Gallstones move, your gallbladder can become infected and rupture if a blockage remains.

People with any of the following symptoms should see a doctor immediately:

• Prolonged pain more than 5 hours

• Nausea and vomiting

• Fever even low-grade or chills

• Yellowish color of the skin or whites of the eyes

• Clay-colored stools

Many people with Gallstones have no symptoms; these Gallstones are called “silent stones.” They do not interfere with gallbladder, liver, or pancreas function and do not need treatment.

Preparation for laparoscopic Gallbladder Surgery

If your doctor allows you to take your medications, the morning of the surgery be sure to only take it with a sip of water.

• If you have a cold, fever, sore throat, or any type of infection it is very important that you alert the medical staff of your condition.

• You may be given antibacterial soap or cleanser by the doctor’s staff. Wash your stomach and abdominal area with the cleanser as instructed, usually the night before and the morning of the surgery. These antibacterial cleansers help reduce bacteria on the surface of the skin. Follow the instructions that accompany the cleanser and be sure to dry the area thoroughly. Since some of these cleansers contain iodine, it’s important to tell the doctor if you have an allergy to this antiseptic.

• Wear loose-fitting, comfortable clothing to the hospital. If you wear pants try to wear ones with a loose elastic waistband that will fit over the bandages.

• Do not wear makeup, perfume, any type of body oils, or nail polish to the hospital. Remove all jewelry, dentures, eyeglasses, and contact lenses prior to the surgery.

• You may want to bring a pillow and leave it in your car to make the ride home more comfortable.

How are Gallstones Treated?

Observation

Most Gallstones are silent.

• If silent Gallstones are discovered in an individual at age 65 (or older), the chance of developing symptoms from the Gallstones is only 20% (or less) assuming a life span of 75 years. In this instance, it is reasonable not to treat the individual.

• In younger individuals, no treatment also may be appropriate if the individuals have serious, life-threatening diseases, for example, serious heart disease, that are likely to shorten their life span. 

• On the other hand, in healthy young individuals, treatment should be considered even for silent Gallstones because the individuals' chances of developing symptoms from the Gallstones over a lifetime will be higher. Once symptoms begin, treatment should be recommended since further symptoms are likely and more serious complications can be prevented.

Cholecystectomy

Cholecystectomy (removal of the gallbladder surgically) is the standard treatment for Gallstones in the gallbladder. Surgery may be done through a large abdominal incision or laparoscopic ally through small punctures of the abdominal wall. Laparoscopic surgery results in less pain and a faster recovery. Cholecystectomy has a low rate of complications, but serious complications such as damage to the bile ducts and leakage of bile occasionally occur. There also is risk associated with the general anesthesia that is necessary for either type of surgery. Problems following removal of the gallbladder are few. Digestion of food is not affected, and no change in diet is necessary. Chronic diarrhea occurs in approximately 10% of patients.

Sphincterotomy and extraction of Gallstones

Sometimes a gallstone may be stuck in the hepatic or common bile ducts. In such situations, there usually are Gallstones in the gallbladder as well, and Cholecystectomy is necessary. It may be possible to remove the gallstone stuck in the duct at the time of surgery, but this may not always be possible. An alternative means for removing Gallstones in the duct before or after Cholecystectomy is with sphincterotomy followed by extraction of the gallstone.

Sphincterotomy involves cutting the muscle of the common bile duct (sphincter) at the junction of the common bile duct and the duodenum in order to allow easier access to the common bile duct. The cutting is done with an electrosurgical instrument passed through the same type of endoscope that is used for ERCP. After the sphincter is cut, instruments may be passed through the endoscope and into the hepatic and common bile ducts to grab and pull out the gallstone or to crush the gallstone. It also is possible to pass a lithotripsy instrument that uses high frequency sound waves to break up the gallstone. Complications of sphincterotomy and extraction of Gallstones include risks associated with general anesthesia, perforation of the bile ducts or duodenum, bleeding, and pancreatitis.

Oral Dissolution Therapy

It is possible to dissolve some cholesterol Gallstones with medication taken orally. The medication is a naturally occurring bile acid called ursodeoxycholic acid or ursodiol (Actigall, Urso). Bile acids are one of the detergents that the liver secretes into bile to dissolve cholesterol. Although one might expect therapy with ursodiol to work by increasing the amount of bile acids in bile and thereby cause the cholesterol in Gallstones to dissolve, the mechanism of ursodiol's action actually is different. Ursodiol reduces the amount of cholesterol secreted in bile. The bile then has less cholesterol and becomes capable of dissolving the cholesterol in the Gallstones.

There are important limitations to the use of ursodiol:

• It is only effective for cholesterol Gallstones and not pigment Gallstones.

• It works only for small Gallstones, less than 1-1.5 cm in diameter. 

• It takes one to two years for the Gallstones to dissolve, and many of the Gallstones reform following cessation of treatment.

Due to these limitations, ursodiol generally is used only in individuals with smaller Gallstones that are likely to have very high cholesterol content and who are at high risk for surgery because of ill health. It also is reasonable to use ursodiol in individuals whose Gallstones were perhaps formed because of a transient event, for example, rapid loss of weight, since the Gallstones would not be expected to recur following successful dissolution.

Extracorporeal Shock-wave Lithotripsy

Extracorporeal shock-wave lithotripsy (ESWL) is an infrequently used method for treating Gallstones, particularly those lodged in bile ducts. ESWL generators produce shock waves outside of the body that are then focused on the gallstone. The shock waves shatter the gallstone, and the resulting pieces of the gallstone either drain into the intestine on their own or are extracted endoscopically.

Laparoscopic Gallbladder Surgery Procedure

During the laparoscopic Gallbladder Surgery procedure, surgeon will make two or three small cuts (about 5 to 10mm long) through the skin of your abdomen. One cut will be above, or just below, your navel (tummy button), and the others on the right side of your abdomen.

Surgeon will then inflate your abdomen using carbon dioxide gas to make it easier to see your internal organs. He or she will then pass a laparoscope (a long, thin telescope with a light and camera lens at the tip) through one of the cuts. This allows your surgeon to view your internal organs on a monitor.

Specially adapted surgical instruments help move the internal organs and allow your surgeon to cut and remove the gallbladder. X-ray images may be taken during the operation, so that your surgeon can see if any Gallstones are blocking your bile duct.

Afterwards, the instruments are removed and the gas is allowed to escape through the laparoscope. The skin cuts are closed with dissolvable stitches and covered with a dressing.

The operation takes 60 to 90 minutes.

How Well It Works

Laparoscopic Gallbladder Surgery is safe and effective.1 Surgery gets rid of Gallstones located in the gallbladder. It does not remove stones in the common bile duct. Gallstones can form in the common bile duct years after the gallbladder is removed, although this is rare.

Benefits of Gallbladder Surgery

In the majority of people removal of the gall bladder and gall stones prevents the painful symptoms that were caused by gall stones.

Gallstones may cause pancreatitis or yellow jaundice and removal usually prevents these from occurring.

Gallbladder Surgery can halt the advancement of gallbladder disease. Gallbladder disease can eventually lead to complications such as jaundice (yellowing of the skin and eyes) and infection of the gallbladder. The removal of the gallbladder may reduce these complications.

Gallbladder Surgery can help stop the progression of gall stones and gallbladder disease.

Removing the gallbladder is beneficial because it stops pain caused by swelling of the gallbladder and Gallstones and prevents the gallbladder from bursting, which can be fatal.

Why Laparoscopic Gallstone Surgery in India

India offers laparoscopic gall bladder surgery for gallstone at a affordable cost with medical tourism in India. The cost difference is significant between India and US for the treatment. India has originated as one of the best import and export hub for medical tourism. Many patients from the developed countries come to India for the rejuvenation provided to them along with their surgery. A nice blend of top class medical expertise at attractive prices is helping more and more Indian corporate hospitals to lure foreign patients especially from UK and US for the high-end surgeries like laparoscopic gall bladder surgery for gallstone in India. Patients from all over the world prefer India as a medical tourism destination for many reasons. Indian has become a medical tourism hub because of its low cost treatment option. It also provides the best medical facilities along with the world class accommodation facility at different health care centers of Delhi, Kerala, Chennai, Hyderabad, Mumbai and Goa.