Gall bladder is a very important digestive gland, which is located on the right side of your abdomen, just beneath your liver. Its main function is to collect, store and release bile, a digestive fluid produced in your liver, essential for metabolizing fats, into your small intestine.

Sometimes, small hard stones comprising of cholesterol, bile pigments and calcium salts in the shape of a pebble, can form in your gall bladder. Gallstones may cause no symptoms but when the gallstone lodges in ducts and blocks the flow of bile, it can cause persistent high-intensity pain which requires gallstone surgery.

Surgery is then prescribed to remove the gall bladder. This surgery is called cholecystectomy. It s done when there are

Gallstones in the gallbladder
Gallstones in the bile duct
Gallbladder inflammation
Inflammation in pancreas
Gallstone surgery or cholecystectomy is a common surgery, and it comes with only a small risk of complications and you can walk out of the hospital on the day of the surgery itself.

Procedure

Minimally invasive or laparoscopic cholecystectomy
During this procedure, the surgeon makes 4 tiny incisions in your abdomen and inserts a tube with a tiny video camera inside it.
Through a video monitor, the surgeon watches while he inserts surgical tools through the other 3 incisions to remove your gallbladder.
After the surgery, the surgeon confirms that there are no gallstones left. Once this is done, he sutures your incisions and you are taken to the recovery area. A laparoscopic cholecystectomy takes just 2 hours or so.
But the problem with this procedure is that it  not appropriate for everyone. Sometimes, what happens is that, the surgeon may start with a laparoscopic surgery and then may decide to go for an open gallstone surgery because of scar tissue or complications.
Traditional or open cholecystectomy
This procedure requires a bigger incision of about 6-inches in your abdomen, below your ribs on the right side. The liver and gallbladder are exposed and the surgeon removes the gallbladder.
An open cholecystectomy takes one or two hours.
Single-incision Laparoscopy Surgery

Traditional laparoscopic surgeries use a telescopic rod attached to a video camera called a laparoscope, which is inserted through a small incision. Apart from this, 3 to 5 additional small cuts are made to insert the other surgical instruments to perform the surgery.

However, single-incision laparoscopy surgery (SILS) is a revolutionary minimally invasive surgical procedure conducted through a single incision. It provides a better cosmetic outcome, as a small incision is made through the patient s navel or belly button, resulting in an almost scarless outcome.

Indications

Most patients who are good candidates for laparoscopic surgery are eligible for single-port procedures. Some of the surgeries that single incision laparoscopy is indicated for include cholecystectomy (removal of gall bladder), appendectomy (removal of appendix), splenectomy (removal of spleen), hepatectomy (removal of liver) and adrenalectomy (removal of adrenal glands). SILS can also be used for diagnostic purposes.

However, patients who have previously undergone multiple major surgeries to the abdominal region and those who are morbidly obese are not considered for SILS.

Procedure

Single Incision Laparoscopy is usually performed as day surgery either in the hospital or outpatient surgery center under general, regional, or occasionally local anesthesia depending on the type of procedure performed and the surgeon s preference.

The patient is made to lie down in a tilted position so that the feet are placed higher than the head. The surgeon makes a single incision of about 3/4th of an inch at the belly button and injects a harmless gas to expand the area and obtain a clear view of the operative site. A tube called a trocar or port is placed through the incision, through which the laparoscope (a narrow telescope having a light source and camera) and tiny surgical instruments are inserted. The laparoscope guides your surgeon with images of the abdominal contents that can be viewed on a large screen. Once the diseased organ is excised, your surgeon removes the instruments, releases the gas, and closes the incision with a small bandage.

Recovery

Common post-operative guidelines following Single Incision laparoscopy include the following:

You will need someone to drive you home after you are released as the anesthesia may make you feel groggy and tired
Do not remove the dressing over the incision for the first two days and keep the area clean and dry.  No showering or bathing during this time.  The incision usually heals in about 5 days
Your surgeon may give you activity restrictions such as no heavy lifting. It is very important that you follow your surgeon s instructions for a successful recovery
You may feel soreness around the incision area. Your surgeon may give you a prescription pain medicine or recommend NSAID s (non-steroidal anti-inflammatory drugs) for the first few days to keep you comfortable
If the abdomen was distended with gas, you may experience discomfort in the abdomen, chest, or shoulder area for a couple days while the excess gas is being absorbed
Diet

You must be very careful with your diet after gallstone removal as your body will not be able to digest fats well. You will of course be sticking to a liquid diet for a week or two and then introduce solids back into your diet. When you do so, you have to stick to a low fat diet. Stay off fried foods and gas-forming foods. Also make sure that you consume no more than 60 gm of fats per meal to avoid discomfort. Stay off spicy foods to avoid bloats and abdominal pains.

Gallbladder Surgery - Aftercare Tips To Help You Recover Better!

The gallbladder can be found under the liver and is a pear shaped organ. This four inch organ is responsible for storing bile, which is a combination of the various fluids as well as fat and cholesterol. These are essential for the body and its metabolism, as the bile helps in breaking down the food that enters the digestive system. With the help of the gallbladder, this bile divides the food into smaller parts within the intestine. This ensures that the energy released by the food is more easily absorbed into the bloodstream. There are a host of problems that can attack the gall bladder including stones, infection and more.

Let us find out the symptoms of a gallbladder attack and the various ways in which it may be successfully treated.

    Pain: One of the most common symptoms of a gallbladder attack includes pain. This can be felt in the section that lies in the middle and the upper right portion of the abdomen. The patient may initially experience mild pain that comes and goes intermittently. Eventually, if the pain is not treated, it can start to radiate on a constant basis and hold the patient in its grip.
    Nausea: Nausea and vomiting are also common symptoms of any gallbladder related problem. Chronic cases usually end up experiencing these symptoms. Nausea and vomiting in such conditions are a result of digestive problems like acid reflux which can be caused due to the gall bladder condition.
    Fever: If there is an infection in the gall bladder, then the patient may also experience fever and chills. This will require immediate treatment and the prescription of antibiotics. If it is not treated on time, the problem can become serious and dangerous.
    Loose Motions: Diarrhoea is a problem faced by many patients suffering from this condition along with jaundice and lighter coloured stools.

Treatment: Mostly, doctors will recommend surgical methods to deal with gall bladder attacks and conditions. A laparoscopic surgery may be conducted to remove the gallbladder. Also, medication will be prescribed to dissolve the gallstones that may have been caused by cholesterol. The patient will also have to undertake many lifestyle changes in order to successfully treat this condition over a period of time.

One will have to avoid greasy and oily food. Also, the fat intake of the patient will have to be reduced so that the cholesterol build up does not affect the gallbladder again. The patient will also have to add fibre to his or her daily diet, in the form of fruit and oats. This will help in improving the bowel movements as well.

The Symptoms and Treatment of Gallbladder Attack

Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

The gallbladder is a small organ in the abdomen that stores bile. Bile is necessary to digest fat that people take with food.

Unlike other cancers, Gallbladder cancer is not very common. It is also treatable in the early stages. However, in most cases, Gallbladder Cancer is detected in late stages. At these stages, the chance of a recovery is remote. What makes early diagnosis uncommon is the absence of specific signs or symptoms.

However, there are some signs that people need to look out for.

Signs of Gallbladder Cancer

Though there are not many specific symptoms, following signs can indicate a broad range of abnormalities, including some cancers.

Pain in the upper right quadrant of abdomen

Bloating

Fever

Weight loss

A feeling of nausea

Yellowing of the skin and eyes (sign of jaundice)

Many of these symptoms may involve other organs or indicate completely different ailments. This is why people need to see the symptoms in light of other concomitant symptoms and gauge the seriousness of the problems. If a person feels that a particular symptom is not solely a gastrointestinal problem, rush to the doctor immediately.

Causes of Gallbladder Cancer

Causes of Gallbladder Cancer are not entirely clear. However, in most cases, cancer spreads from the glandular cells of the gallbladder. These cells are found in the inner body of the gallbladder. This is also known as Adenocarcinoma. Slowly, it spreads from the inner body to other organs of the body.

Risk Factors

Though the reasons for Gallbladder Cancer are not yet known, certainly there are some factors that exacerbate the risk:

Gender
More women than men suffer from Gallbladder Cancer.

Age
The risk of Gallbladder Cancer increases with age.

History of Gallbladder Stone
It has been observed that most of the Gallbladder Cancer patients have had a history of gallbladder stones. However, this does not mean that Gallbladder Cancer is common in people with a history of gallbladder stone.

Chronic gallbladder infection, gallbladder polyps, etc. can increase the risk of Gallbladder Cancer.

Stages of Gallbladder Cancer

Gallbladder Cancer is categorized into different stages in accordance with its spread:

Stage I
If cancer is confined within the glandular cells of gallbladder, it is put in this stage.

Stage II
If cancer has grown out of the inner layers and has invaded the outer layer of the organ, it is put in the second stage.

Stage III
If cancer has grown to such an extent as to invade nearby organs like liver, stomach, small intestine, etc., Gallbladder Cancer is put in this stage.

Stage IV
The last stage of Gallbladder Cancer is characterized by large tumors, taking into their fold multiple organs in the vicinity. Tumors may also spread to distant parts of the body.

Treatments of the Gallbladder Cancer

The treatments depend a lot on the stage of cancer and overall health. The primary goal is to remove the diseased gallbladder. It may also be possible to resect part of the liver and bile duct along with the gallbladder.

However, if that is not possible, doctors may need to resort to other therapies to prevent the disease from spreading. This may involve Radiation Therapy or Chemotherapy or a combination of both.

There are many treatments available for Gallbladder Cancer depending upon the severity of the cancer. This is why it is important to consult a doctor before opting for any treatment.

Gallbladder Cancer - Signs, Causes & Treatment Of It!

Gallstones are small stones that form in the gallbladder as a result of the deposits caused by the bile, a type of digestive fluid. Actually, the gallbladder stores bile and releases it into the duodenum (part of the small intestine) for the digestion of fats. However, when the gallbladder is unable to release the bile properly, the bile deposits start building up and manifest in the form of stones. These stones vary in size, ranging from tiny sand-like grains to big golf ball-like stones.

Symptoms of gallstones: Many times, individuals have stones in their gallbladder and yet they do not experience any discomfort. These stones are very small in size and therefore, do not cause trouble. This is why they are called silent stones and for such individuals, treatment is not needed. But if an individual experiences discomfort, it is a signal for treatment. The signals come in the form of specific symptoms such as pain in the upper right side of the abdomen, pain between the shoulder blades, nausea, vomiting, fever, and even jaundice.

Causes of gallstones: Gallstones may result due to common. Excess bilirubin produced by the liver causes hard, dark brown stones called pigment gallstones. Even when the gallbladder cannot empty the bile, stones are formed due to the concentration of bile.

Treatment: Once gallstones are detected through a CT scan or ultrasound, the doctor begins the course of treatment. Gallstones can be removed only through surgery. In surgery, the gallbladder is removed to help the bile flow directly into the duodenum from the liver. This surgery is called cholecystectomy and it is a safe procedure. The removal of gallbladder does not affect the digestive system in any way. 

Prevention: Gallstones can form in any individual s gallbladder but some people are more susceptible to the condition. Such individuals include women over 40, those who lead a sedentary lifestyle, obese/overweight individuals, and those with a family history of gallstones. Therefore, such people should be aware of the risk they face. If such individuals report any symptoms related to gallbladder stones, they should get it diagnosed immediately. Apart from this, one should also keep a check on the diet. A high-fat or high-cholesterol diet should be replaced with a high-fiber diet and one should also take meals on time. Not eating anything for long hours and fasting increases the risk of gallstones. Regular exercise also helps in this matter. Last but not the least, one should drink plenty of water as it regulates the functioning of the liver and prevents the formation of stones. Gallstones are a common disorder but they cause difficulties for the patient and hence, one should get it treated on time. If surgery is recommended, one should not delay it and get it done as soon as possible. Delay only aggravates the problem.

Gallstones - What All Should You Know About It?

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