GALL BLADDER
What is the Gallbladder?
The gallbladder is an organ that looks like a money bag and is connected to the liver. Its job is to store the bile that the body makes. Bile is especially important for how our bodies break down fats. So, when we are hungry, the gallbladder stores the bile that the body makes. So, when we eat fatty foods, especially, all the bile in the warehouse is moved into the glass, allowing the fat to be absorbed properly.
What is Gallstone?
Gallstones are small stones that usually form in the gallbladder, but they can also form in the biliary tract if the gallbladder is not working right. There are different kinds of these rocks. Cholesterol stones are the most common. They start out as biliary sludge and then harden into stones. Even though most people get it, it can also be caused by their genes. Again, it is most often seen in the gallbladder, but it can sometimes be seen in the biliary tract or even in the bile ducts inside the liver.
What Are the Symptoms of Gallstones?
Gallstones are small stones that form in the gallbladder. Bile sludge does not always look like a stone; sometimes it looks like sand. There may be more than one reason. In the foreground, you can see things like genetics, eating habits, and problems with the way the body is built. It usually shows up as pain in the abdomen, especially on the right side, under the ribs, and after eating fatty foods. This pain often feels like cramps and is similar to gas pain. It often moves to the back and sometimes feels like a belt around the middle of the body. Most of the time, this pain comes with nausea, vomiting, a high fever, and chills. Especially if the gallstone falls into the bile duct and blocks it, these problems get worse, and after a while, jaundice starts to show up. If this blockage also stops up the pancreatic duct, a much worse problem called pancreatitis happens, which is very important. In this case, the person needs to stay in the hospital before the surgery.
How is Gallstone Diagnosed?
Whole abdominal ultrasound is the best way to find out if someone has gallstones. To get accurate results from the ultrasound, you must not have eaten for at least 4 hours before the procedure. Because when the stomach is full, the gallbladder shrinks and can not be seen, even if it has a stone in it. Tomography is another method that can be used in some advanced cases. But MR Cholangiography should be done so that the bile ducts can be seen clearly, especially if he/she thinks the gallstone fell into the duct. If there is a stone in the duct, and it is blocking the duct, the bile ducts should be cleaned with ERCP before the surgery, and the surgery must be done after the patient’s acute symptoms have gone away.
What Causes Gallstones?
The gallbladder is a small sac that stores extra bile. Most of the time, cholesterol crystals form in the bile, which is drained here, when the cholesterol level is too high. When these crystals stick together, gallstones are formed. This is the cause of 80% of gallstones. But this usually happens because the chemical structure of saffron is changing. People who are female, older than 40, overweight, have a family history of gallstones, have high cholesterol, or have sickle cell anemia are more likely to get it. Food does not cause the disease directly, but eating fatty foods, eggs, chocolate, and frying can make the disease worse.
Who Gets Gallstones?
Gallstones can happen to people of any age or gender, but they are more likely to happen to
- over 40 years old,
- women
- obese people,
- people who have given birth a lot, and
- people with white skin.
- It happens to about one-third of people over the age of 60.
- Gallstones can form in some people who gain and lose weight quickly.
- It happens more often in diseases of the blood that cause hemolysis.
- Those with diabetes who have liver disease, especially cirrhosis caused by alcohol.
- During pregnancy, bile sludge can cause birth defects of the gallbladder.
- Most of the time, it goes away by itself.
How is gallstone treatment done?
Even though some drugs are used to treat gallstones, this is often not enough and the stones come back. Gallstones can cause a very serious disease called pacreatitis and jaundice, especially if they fall into the biliary tract and block it. This can happen if they are not treated or if they are treated incorrectly. Because of this, if there is a stone in the gallbladder, surgery should be planned and the gallbladder should be removed before the risk of pancreatitis develops and before an emergency happens.
Everyone wants to know if it is okay to take the stones in the gallbladder and not the gallbladder itself. It is not clear what to do. Because if the gallbladder makes stones, it will be useless after the surgery, which we will do by taking the risks of the surgery, and there will be gallstones again in a month. We do not do surgery on people who have gallbladder stones. We take out the gallbladder because it makes stones and is not as strong as it should be. So, during surgery, the whole gallbladder is taken out.
How is Gallbladder Surgery Performed?
There are two ways to do gallbladder surgery: closed and open.
In the open method, a cut about 15 to 20 centimeters long is made under the right ribs, along the curve of the ribs. The gallbladder is then reached under the liver and removed. This method is almost no longer used. But open surgery can sometimes still be done on people who have already had an operation in that area or whose adhesions are very strong because of an acute picture. With open surgery, there is a much higher chance that the wound will heal than that there will be wound complications. So, it is not the best choice.
Closed gallbladder surgery (laparoscopic)
Laparoscopic gallbladder is done by 2 methods. Laparoscopic and scarless method.
Laparoscopic gallbladder surgery:
With special laparoscopic tools, there is a cut of about 1 cm from the navel and 3 cuts of 1 cm. About 45 minutes are needed. It is the method most people use. After the surgery, you will spend one night in the hospital. If the person does not do heavy work, they have to go back to work on the third day. The difference between this and open surgery is that there are fewer wounds, so the patient can heal quickly and without pain. Also, there are not any problems with wound healing after surgery because there are not many cuts. There is less risk of getting sick or bleeding.
Scarless gallbladder surgery:
With the help of a special tool, a cut about 2 cm away from the belly button is made. When it comes to laparoscopic surgery, there are no major differences. There is no scar because only one cut is made from the belly button. Again, there is a very small chance that the wound will hurt or get sick. he/she spends one day in the hospital. The next day, he/she is let go. After 3 days, he/she can go back to work. Scarless surgery is different from laparoscopic surgery in that there are no scars. Even though this surgery is very helpful, you definitely need experience to do it.