Diseases of Gall Bladder
- Gall bladder stone
- Acalculous cholecystitis
- Tumours of gall bladder (90% malignant)
- Gall bladder polyp ( pre- malignant condition , that can lead to gall bladder malignancy)
- Cholesterosis of gall bladder ( deposit of cholesterol on gall bladder wall, pre malignant condition)
- Dysfunction or non functioning gall bladder
Complications of Gall Bladder Stone
- Empyema gall bladder ( severe inflammation and infection of gall bladder with pus )
- Cholangitis ( infection of gall bladder)
- Obstructive jaundice (gall stone migrating in to main bile duct causing obstruction, leading to jaundice and infection)
- Gall stone acute pancreatitis (self destruction of pancrease stimulated by migrated gall stone , can be vert fatal , involving all the organs of the body)
- Malignancy of gall bladder (cancer of gall bladder , most common with large gall bladder stone , in neglected cases, or few genetic disorders that run in families )
It is done under general anaesthesia after anaesthesia check up , and necessary pre operative investigations.
4 holes are made in abdomen and the abdomen in inflated with carbon dioxide gas , and entire operation is done under video assistance.
- Minimal pain
- Minimal bleeding
- Early recovery and short hospital stay (48 hrs)
- Less loss of working days
- Minimal chance of infection
- Minimal chance of post operative incisional hernia
- Six times magnified image of abdomen and better visualisation of entire abdominal organs .
TREATING COMPLICATIONS OF GALL STONE
COMMON BILE DUCT STONE WITH JAUNDICE
ACUTE GALL STONE PANCREATITIS
GALL BLADDER CANCER
All patients with gall bladder disease ,except patients with heart failure , severe respiratory disease, gross infection of gall bladder, advanced malignancy of gall bladder, ascitis, history multiple open surgeries of abdomen, and any a condition where general anaesthesia can not be administered .
Patients with no co- morbidities like hypertensions and diabetes , usual hospital stay is 48 hours approximately .
No gall bladder is not essential for digestion , it acts as temporary store house of bile ,and bile helps in fat digestion ,and after operation patient continues with normal life style .
Fat free diet is recommended before operation , and after operation for 4 weeks.
World wide the chance of conversion to open surgery may be 5-15% , varies from institution to institution ., if the anatomy could not be ascertained by video assistance as 45 % of population have anomaly of gall bladder, or due to gross infection.
If the anatomy can not be ascertained by the surgeon, due anomaly of anatomy or gross infection called Mirrizi syndrome , sub total cholecystectomy is advocated by authors , and in those cases chance of residual stone is .2 -2 % . Re operation may need to be undertaken either open or laparoscopy.
With gaining experience of laparoscopic surgery for last 25 years of the surgical community , the chance of complication is very less ,involve injury of commob bile duct , bleeding nd occasional post operative pancreatitis ( very less for laparoscopic surgery) .