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

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 solid deposits/stones of digestive fluids that form in the gall bladder. The size of these stones varies from person to person. While some people may develop only one stone in the bladder, others may develop multiple gallstones simultaneously.

Signs you must watch out for-

Abdominal pain
Pain in the back or between the shoulder blades
Vomiting and nausea
Heartburn
Bloating and indigestion
Change in bowel movement
Dark urine
Fever and chills
Rapid heartbeat
Yellowish skin and pale eyes (Jaundice)
These are the most common symptoms that a person with gallstones encounters. One should consult the doctor right away upon experiencing these symptoms. If ignored for long, these signs can aggravate and lead to further complications.

Complications that may arise from gallstones-
There are quite a few complications of gallstones, including the following-

Cholecystitis- when gallstones become stuck at the neck of the gallbladder, it causes inflammation.
Obstruction in the pancreatic duct- a gallstone blocking the pancreatic duct can cause pancreatitis followed by intense abdominal pain.
Blockage in the bile duct- if the gallstones create a blockage in your bile duct, the outcome may be an infection or jaundice.
Gallbladder cancer- people, who have a history of gallstones, are more likely to develop gallbladder cancer.
Treatment of Gallstones-
Gallstones can certainly be treated, if diagnosed early in time. To confirm the diagnosis, your doctor may perform a CT scan, X-ray, Ultrasound or an ERCP. Once the condition is diagnosed, your doctor will recommend a surgery to remove the stones in the gallbladder (known as Cholecystectomy). The preferred choice of surgery includes the following-

Laparoscopic removal- In most of the cases, the doctor adopts this minimally invasive approach to remove gallstones. First, he makes a small incision in the abdomen. He will then insert a tube-like instrument with an attached camera into the gallbladder to have a clear sight of the gallstones, and surgically remove them from the gallbladder.
Open surgery- This is performed under general anesthesia. During this procedure, a single, long incision of roughly 3-6 inches is made on the upper side of your right abdomen. The tissues and muscles are pulled back to divulge the gallbladder. The gallstones are then removed, and the incision stitched up. Open surgery is performed when laparoscopic surgery is not suitable for the patient.
Gallstones cannot be managed with just diet and medications. A surgery is usually needed to remove the stones and cure the patient. For Laparoscopic surgery, the rate of success is nearly over 95%. Identify the symptoms before it aggravates, and consult a doctor for treatment.

Gall Stones - Is Surgery The Only Treatment?

Gallstone Pancreatitis is the result of a blockage in the pancreatic duct by a gallstone. Due to the blockage in the pancreatic duct, inflammation occurs and causes the problem to begin.

This can be a life-threatening situation and should be immediately checked. If the stones from the gallbladder travel down the common bile duct and get stuck at the sphincter, it can stop the outflow of all materials from the pancreas as well as the liver and become quite severe. There are a lot of risks involved when a person suffers from this issue. Rapid weight loss, high cholesterol levels, diabetes are a few of the risks of the disease.

Symptoms of Gallstone Pancreatitis
There are a number of symptoms like pangs of pain in the upper left abdomen and the back, swollen and tender abdomen, vomiting and nausea, increase in the heart rate, fever and more can be seen in a patient suffering from gallstone pancreatitis. Any individual who notices any of the following symptoms should get themselves checked immediately. Any pain in the upper abdominal area can be aggravated by eating foods which are high in fat as well.

Diagnosis of Gallstone Pancreatitis
In order to be completely sure about having gallstone pancreatitis, a number of tests are performed. Blood tests are followed by abdominal CAT scan to check for the inflammation of the pancreas. This also shows how severe the inflammation of the pancreas is. Sometimes abdominal ultrasound is also suggested as CAT scans are sometimes not as sensitive in identifying the problem. Once the problem has been detected, immediate treatment is recommended by doctors.

The Treatment of Gallstone Pancreatitis
The best treatment for pancreatitis is done in the initial stage of the problem. By avoiding taking in liquids and solid food up until the inflammation subsides is one of the best treatments. If the inflammation is relatively modest, the swelling can reduce in a few days by intravenous delivery of fluids for a couple of days.

1. If a CAT scan or MRI of abdomen suggest that a stone in present in the Common bile Duct (CBD), the an Endoscopic treatment referred as ERCP (endoscopic retrograde cholangio-pancreatography) is done. 

2. After the acute pancreatitis episode settles down, patient must undergo a Gall Bladder removal surgery. This is done as gall bladder is the factory of gall stones and patient is at-risk to another episode of Acute Pancreatitis.

In case of severe inflammation, fever and persisting pain, intravenous delivery of food should continue if oral intake of food does not start within 5 to 7 days. Anti-nausea medications are used to treat severe nausea and vomiting along with nasogastric tube. In certain cases, it is important to remove the gallstones from the bladder immediately while in some cases doctors suggest waiting for a period of 24-48 hours before starting the removal procedure. Sometimes a surgical removal of the gallstones is also required but only if the stones do not pass out of the system on their own.

All You Need to Know About Gallstone Pancreatitis

These Gallstones don t cause any problems in most cases. But prompt treatment is required if stones block ducts and cause infections and inflammation in the pancreas. This may lead to the removal of the gallbladder through a surgery, known as cholecystectomy, which further includes techniques such as laparoscopic (keyhole) cholecystectomy or open surgery.

Although it is a less vital organ, the body can cope up even after removal.

Procedure of surgery:

The surgery involves removal of gallbladder and gallstones through several incisions in the abdomen. In order to see clearly, the surgeon inflates the abdomen with air or carbon dioxide.
A lighted scope attached to a video camera is inserted into one incision near the belly button. The video monitor is used as a guide for inserting other surgical instruments into the other incisions to remove the gallbladder.
Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
Bile flows from the liver through the common bile duct after the surgery into the small intestine. As the gallbladder has been removed, the gallbladder can no longer store bile between meals but has no effect or little effect on digestion.
In case of open surgery, the surgeon reaches the gallbladder through a large, single incision in the abdominal wall.
Complications after gallbladder surgery:

This surgery carries some degree of risk like any other surgery. Complications such as internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct and injury to blood vessels.

Types of gallstones:

There are three main types of gallstones. They are

Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
Pigment stones: The colour of bile is greenish-brown, due to some particular pigments.
Medical factors to consider before cholecystectomy:

The most important factor is a consideration of your medical history. This is because the pre-existing conditions influence decisions on surgery and anaesthetic and information about any bad reactions or side effects from any medications would be helpful for surgery.

Self-care after the surgery:

Taking rest is the most important thing after surgery. Avoid things such as heavy lifting and physical exertion. The usual recovery period after the surgery is one week.

Know Everything About Gallstone Surgery!

When you experience a pain on the side and back just below the ribs that at times radiates to the lower abdomen and is fluctuating in intensity, it is quite unlikely for you to think that the reason could be a kidney stone. One of the early symptoms of kidney stone, when you experience such pain, you must seek medical advice. However, there is no need to panic as it is completely curable. Read on to understand more about this condition.

What is urinary bladder stone?
Vesical calculus, which is more commonly referred to as bladder stones, are formed due to a buildup of minerals. It may occur when the bladder is not entirely emptied after urinating. In the course of time, the residual urine becomes concentrated, and the minerals start forming crystals. When the stones are in a miniature state, they can easily pass out, but at times, when they are quite big, they may get stuck in the walls of the urinary tract and cause severe pain and discomfort.

What are the causes of urinary bladder stones?
Bladder stones start growing when the urine is left in the bladder for a long span of time. This may happen due to some underlying medical condition which can prevent the bladder from completely emptying. Conditions which are responsible for causing stones in the urinary tract are as follows

Enlargement of the prostate: When the prostate is enlarged, it may exert pressure on the urethra and disrupt the flow. It leads to retention of urine and creates an ideal environment for the formation of stones.
Diverticula and enlargement of bladder: Sometimes, pouches form within the bladder, and when they become too large, they can retain urine and prevent the bladder from being emptied completely.
Usage of medical devices: Bladder stones may form when an individual uses catheters or other medical devices.
Inflammation of the bladder: Radiation therapy or infection in the urinary tract that causes inflammation or enlargement of the bladder can lead to the formation of stones. Also, if a person has kidney stones, they can come down to the ureters, and in case they become too large to pass, they would stay in the bladder and cause substantial obstruction. Kidney stones are more common than stones in the urinary bladder.
How are kidney stones treated?
Specific lifestyle changes such as drinking enough liquids, taking calcium supplements, limiting the amount of caffeine and alcohol and reducing body weight are some of the simplest yet effective means of treating urinary stones at earlier stages.

Use of specific medicines can also reduce the calcium and uric acid stones by controlling the amount of alkali or acid in the urine. These medications reduce the amount of calcium released by the kidneys so that they can be retained in the bone. If these treatment options do not work, you must consider undergoing surgical intervention.

Stones In Urinary Tract - 4 Particular Reasons Behind It!

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