Gallbladder Biliary Surgery

We provide diagnostic and therapeutic endoscopy services with wide spectrum.

Gallbladder Biliary Surgery

BENIGN

Acute cholecystitis

Gallbladder Biliary Surgery

The prevalence of gallstones

Women, 20%; men, 5%, although there is formidable ethnic predilection with gallstones endemic in INDIA. Gall stones more prevalent in north india.

Percentage of asymptomatic gallstones convert to symptomatic gallstones

10% at 5 years, 15% at 10 years, and 18% by 15 years.

The incidence of gallbladder perforation in patients with acute cholecystitis?

5 Percent.

GALLSTONES

KEY POINTS: GALLSTONES

  • 15-20% of patiens with gallstones become symptomatic.
  • If gallstones become symptomatic, cholecystectomy is required.
  • In the U.S., 75% of gallstones are cholesterol stones; in Asia, pigment stones are more common.

What is the incidence of acalculus cholecystitis?

10% of all cases of cholecystitis.

What is the prevalence of gallbladder carcinoma found incidentally during cholecystectomy?

Open, 1%; laparoscopic, 0.1%.


Should patients with asymptomatic gallstones undergo laparoscopic cholecystectomy?

No. The risk of observation of patients with asymptomatic gallstones is less than or equal to the risk of operation.

In what groups of patients with asymptomatic gallstones is prophylactic cholecystectomy beneficial?

  • Patients with congenital hemolytic anemia who have gallstones at the time of splenectomy
  • Obese patients undergoing bariatric surgery who have already developed gallstones

What is the optimal timing for laparoscopic cholecystectomy in acute cholecystitis?

Within 72 hours of the onset of symptoms. Procedures performed within the first 48 hours generally are easier because the area of dissection is not yet maximally inflamed. Fibrosis and increased blood vessel proliferation have not yet occurred.

Gallstones may pass from the gallbladder into the common bile duct and cause several problems, including:

  • Pancreatitis-a stone may temporarily obstruct the pancreatic duct as it moves into the duodenum and cause pancreatic inflammation due to bile reflux in the pancreatic duct. Most often the gallstone has passed into the duodenum.
  • Obstructive jaundice-a stone may lodge in the common bile duct, preventing the drainage of bile so the patient has symptoms and signs of obstructive jaundice.
  • Ascending cholangitis-if infection develops in an obstructed biliary system, the patient is seriously ill with fever, rigors, and jaundice (Charcot's triad) and is at risk of developing septicemia.
  • An uncommon complication of chronic gallstone disease is the development of carcinoma of the gallbladder. It is usually discovered late when it has already invaded adjacent structures so that the prognosis is poor. Occasionally carcinoma of the gallbladder is an incidental finding after cholecystectomy.
  • Pathologically more than 80% of gallbladder carcinomas are adenocarcinomas and less than 5% are squamous cell carcinomas.
  • Gall bladder polyps
  • Gall bladder perforations
  • CHOLEDOCHAL CYST
  • Bile duct stones

  • Cancer

    • Gall bladder cancer
    • Bile duct cancer
    • Biliary cystic tumors
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