Gallstone
disease is often painful and debilitating. Symptoms include nausea, vomiting, bloating,
indigestion, as well as pain originating in the upper abdomen but often radiating to the
back or shoulder. These can be mistaken for signs of peptic ulcer disease, acid reflux or
even a heart attack. Although anyone may develop gallstones, not everyone has symptoms
from them. Overweight people, women who have been pregnant, those who eat large amounts of
fats in their diet and those with strong family histories of gallstones are at risk. The
function of the gallbladder is to store the bile that is made in the liver. During the
normal digestive process, the gallbladder squeezes to release bile that aids in the
absorption of fats and fat soluble materials. A derangement in the chemical makeup of the
bile can cause stones to form in the gallbladder. The stone that blocks the bile duct can
cause recurrent episodic pain, unrelenting pain and fever, or even jaundice.
The evaluation of the patient with suspected gallstone disease (cholelithiasis,
cholecystitis) starts with a thorough history and physical examination. The patient's
symptoms and the findings on physical exam may lead to the ordering of an abdominal
ultrasound to confirm the presence of gallstones. Blood tests or chemistries can help
determine the extent of disease.
Treatment choices are often dictated by the severity and acuteness of the condition.
Medications to dissolve stones are seldom very effective and have side effects that make
them difficult to take long term. Surgical intervention is the best and surest way to
treat the diseased gallbladder.
Ten years ago the treatment of choice involved the use of a large, painful upper
abdominal incision to remove the gallbladder (cholecystectomy). This has been replaced in
most cases by the utilization of the laparoscope or videoscope. By this method a camera is
placed into the abdomen. Through small incisions, long instruments are used to remove the
organ and its stones. Occasionally, x-rays are taken of the bile ducts to look for
migrating stones. The entire procedure takes about an hour and can often be performed as
an outpatient. Recovery time is much shorter and pain much less than by the older method
of open gallbladder surgery. For this reason, most can return to work in just a few short
days.
Since the gallbladder only stores the bile made in the liver, the surgical removal of
the organ has very few side effects, the most common being short-lived minimal diarrhea.
The experience of the physicians at Advanced Surgical has helped to improve our
patients' lives, returning them to an active and healthier lifestyle in the shortest
possible time.
