Following are some common Gall Bladder and Biliary Disorders. Read on to know in brief about them. 

1. Gall stones: Gall stones also known as cholelitiasis is a condition in which gall bladder contains stones or calculi. Usually, these stones are asymptomatic and do not cause any trouble to the patients. Few patients experience recurrent right upper abdominal pain. This condition is known as biliary colic and if it persists, the patiet is adviced gall bladder removal surgery. Sometimes the patient presents with severe right upper abdominal pain with fever and deranged Liver function tests. This condition is known as acute cholecystitis. The surgery is minimally invasive and is called Laproscopic cholecystectomy. If there are dense adhesions, the surgeon may plan to convert the surgery to open cholecystectomy. The patient is usually discharged by day 3 of surgery.

2. Common bile duct stone or choledocholithiasis: Occasionally stone from the gall bladder slips into the common bile duct (CBD stone).This causes obstruction of the bile duct causing Fever, abdominal pain and Jaundice. This is called Cholangitis and is a medical emergency. The patient requires urgent hospitalisation and decompression of the bile duct by inserting a plastic stent in the CBD with the help of ERCP. Severe untreated cholangitis can be life threatenig.CBD Stones which are detected because of dull aching abdominal pain, deranged liver function tests or by ultrasonography also need removal. The CBD stone is removed by an endoscopic modality called ERCP, which is minimally invasive and needs no surgery.

3. Bile duct cancer or cholangiocarcinoma: Cancer of bile duct usually occurs in the elderly patients who present with gradually progressive jaundice. Because of the obstruction to the flow of bile, produced in the liver, the patient develops jaundice. Gastroenterologists examine the patient and CT scan abdomen with MRCP is required to fully evaluate the stage and extent of the tumour. The treatment is multimodality and requires the expertise of Radiologists, Surgeons, Oncologists and gastroenterologists. The Gastroenterologists can help in decreasing Jaundice by inserting plastic or a metal stent (SEMS self-expanding metal stent ) in the common bile duct. These are very aggressive tumours and very few patients are fit for surgery. Survival is very low for these tumours.

4. Gall bladder cancer: Gall bladder cancers are very aggressive and lethal cancers. The patients present with obstructive Jaundice and Itching all over the body. Definitive treatment is surgery but very patients present in the early stage. Advanced stage cancers are treated with palliative intent by metal stenting (SEMS for cancer of gall bladder) to reduce jaundice.

Learn More About Gall Bladder And Biliary Disorders!

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!

Surgeons perform the Laparoscopic Cholecystectomy Procedure when there is an obstruction to the flow of bile from the gallbladder to the digestive system. This may happen due to the formation of stones in the gallbladder. 

In case there is stone in the gallbladder, it calls for the removal of gallbladder. If the gallbladder is not removed, it may give rise to abdominal pain, nausea, vomiting, pain in the shoulder, arms, etc. It may also lead to jaundice and infection and put the pancreas in difficulty. The gallbladder removal procedure can be carried out through the Laparoscopic Cholecystectomy.

In this procedure, the gallbladder is removed from the abdomen through small incisions using a laparoscope and other surgical instruments. A total of five incisions are made into the abdomen.

Role of Gallbladder and Why Laparoscopic Cholecystectomy is Needed?

The gallbladder is a pear-shaped organ located at the right side of the liver. It helps the digestive system of the body. The gallbladder stores the bile juice made by the liver. This bile juice helps in digesting the fat. If there are stones in the gallbladder, it can block the flow of bile fluid, which affects the functionality of digestive system. This problem is known as Gallstones. A Laparoscopic Cholecystectomy is performed when there is a stone in the gallbladder.

What Is a Laparoscope and How Is It Used?

A laparoscope is a narrow tube-like structure that carries a camera in front of it. This instrument is inserted through a small incision and the doctor manipulates it to view the targeted area clearly. He can view the area clearly on the monitor. Surgical instruments are then inserted through other incisions, and the gallbladder is removed.

The Procedure:

Before the procedure, the patient is administered with general anesthesia. This relaxes the muscles and prevents pain. The patient falls asleep and the doctor carries out the procedure. Carbon dioxide is inserted into the abdomen to inflate it. After this, a small incision is made in the navel and the laparoscope is inserted through it. The surgeon may also perform an X-ray to confirm the existence of stones in the common bile duct. Once he is confirmed about the existence of stones, he inserts surgical instruments through other incisions. The surgeon removes the gallbladder through these incisions.

What Are the Benefits of Laparoscopic Cholecystectomy Procedure?

There are many benefits of Laparoscopic Cholecystectomy over open gallbladder removal:

The patient suffers less discomfort compared to regular surgery.

The patient also needs to stay in the hospital for a lesser number of days as compared to open surgery.

The patient also suffers smaller tears as compared to open surgery.

Risks of Laparoscopic Cholecystectomy:

The risk of complications is low in a laparoscopic procedure. However, there are still some risks, that include:

Infection

Business

Injury to the common bile duct

Shoulder Pain

Leakage of Bile

Conclusion:

Laparoscopic cholecystectomy has become a popular option for patients suffering from gallbladder stone. Surgeons often suggest this procedure so that patients can recover quickly and there is minimal bleeding. However, the laparoscopic surgeon must be experienced to perform this type of surgery. An experienced laparoscopic surgeon can ensure that there are minimal bleeding and little risk of other side effects during the procedure. The patient must be able to recover quickly and get back to his routine.

Laparoscopic Cholecystectomy Procedure!

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!

Surgery using a laparoscope is the most common way to remove the gallbladder. A laparoscope is a thin, lighted tube that lets the doctor see inside our belly. It is a minimally invasive surgery in which small incisions and specialized tools are used to remove a diseased or infected gallbladder.

The gallbladder is a small organ that sits right under the liver and is credited with bile storage, which can help the body in breaking down various kinds of fats that enter it. So, what all do you need to know about this operation? read this list.

Reasons for gallbladder operation
The gallbladder is not a very efficient organ. It can lead to blockages and choking as the bile it stores can become very thick and difficult to handle. Also, this bile can harbour deposits that are hard ball like substances, usually known as gallbladder stones. The size of these stones can vary from the size of a grain to the size of a golf ball. 

Further, these gallbladder stones can cause infections, which can lead to symptoms like nausea, vomiting, bloating and more. Another reason can also be the gallbladder disease known as chloelithiasis, which can cause abdominal pain. Inflammation in the pancreas, also known as pancreatitis, can lead to gallbladder open removal surgery.

Risk
While the gallbladder removal surgery is usually considered a safe one, with little or no complications, there are risks attached to this surgery too. These include sudden and excessive bleeding and the creation of blood clots, allergic reactions to the drugs used as well as anaesthesia, blood vessel damage, accelerated heart rate which leads to an increased risk of contracting a heart attack or heart disease, infections, inflammation or swelling in the pancreas, and injuries caused to the bile duct during surgery.

You might also need this type of surgery if you have the following:
1. Biliary dyskinesia, which occurs when the gallbladder doesn't fill or empty correctly due to a defect
2. Choledocholithiasis, which occurs when gallstones move to the bile duct and potentially cause a blockage that prevents the gallbladder from draining
3. Cholecystitis, which is an inflammation of the gallbladder
4. Pancreatitis, which is an inflammation of the pancreas

Laparoscopic surgery is preferred over open cholecystectomy surgery because the smaller incisions that are made reduce your risk of infection, bleeding, and recovery time.

Preparation
To prepare for your gallbladder removal surgery, the doctor may ask you to have a prescription fluid so that your bowels are flushed clean. You may also be asked to fast for at least six hours before the surgery so that there is no hindrance to the same. Also, the use of an antibacterial soap to bathe is usually prescribed so that the risk of contracting infections decreases.

While this surgery can be a simple one, you will have to take due care after the surgery to ensure that the recovery is fast and virtually pain free.

All About Gallbladder Surgery

Since the development of modern medicine, doctors and health care professionals have always tried to come up with minimally invasive procedures for both diagnostic purposes as well as surgery. Endoscopy was developed to see inside a human body without the need for large incisions or surgery.

What is Endoscopy?
Endoscopy is a type of procedure wherein the doctor inserts a long thin tube into the body through an opening such as the mouth, anus or the urethra. Sometimes small incisions may be made on your body to insert the tube as well. The tube which is inserted within the body is fitted with a camera which allows the doctor to see what is wrong within your body, a specific section or organ. Doctors can even take images or videos of your organs which help them to determine a due course of action in your treatment. Endoscopy may also be used as a part of a laparoscopic operation to correct problems within the body, especially in cases wherein tissues have to be removed.

Types of endoscopy and its uses-
Although endoscopy could be used in any part of the body, there are certain areas where they are used more commonly than the others. Some of the types or endoscopies are mentioned below:

Colonoscopy   Used to examine your colon wherein the scope is inserted through your anus
Laparoscopy   This is one of the most common forms of diagnosis as well as surgery wherein the tube may be inserted through a small area in your abdomen or the pelvic area. This is not only used for imaging or diagnosis but is used in surgery as well.
Arthroscopy   Here, an incision is made on the joints of your body to check for problems
Cystoscopy   In this type, the tube is inserted through the urethral opening to check for problems in the urinary tract or the bladder. Another variation of this would be ureteroscopy.
Enteroscopy   This is an endoscopic examination of the intestines wherein the tube is inserted via the anus or the mouth.
Hysteroscopy   Here, examination of the uterus and the female reproductive organ is carried out wherein the endoscope is inserted into the vagina.
Bronchoscopy   It entails an examination of the lungs wherein the scope may be inserted through the nose or mouth to check the lungs
Upper gastrointestinal endoscopy - This is used for the examination of the esophagus and the upper intestinal tract.
Risks and safety-
Endoscopy is a widely performed and very reliable procedure. In the hands of a skilled doctor, endoscopy will be able to determine the cause of the problem and also correct the issues if surgery is also performed along with it. However, like any procedure, it does carry certain risks although the chances are fairly low. Some of the risks are mentioned as follows  

Perforation or other injuries to your organs such as scraping or bruising
Fever due to the introduction of foreign materials
Persisting pain in the specific area wherein endoscopy was performed
Swelling of the area wherein the tube was inserted
Infections after the procedure
Bleeding at the site of the incision or entry of the tube
However, these cases are rare and only occur in a very small section of the cases. Although there is minimal pain associated with the procedure, the benefits far outweigh the risks and inconveniences.

8 Types Of Endoscopies & For What They Are Used For!

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