Who are surgeons who remove a gallbladder
Gallbladder removal (biliary surgery, cholecystectomy)
Role and function of the gallbladder
The gallbladder is a pear-shaped organ that lies on the underside of the liver. Its function is to store the bile secretion and concentrate it by removing water.
The bile secretion is formed in the liver cells and reaches the gallbladder via the liver duct. The gallbladder itself does not make bile. The bile secretion consists of water, electrolytes, bile acids, cholesterol, bilirubin and many other substances. The bile secretion is important for the elimination of drugs, toxins and breakdown products from the body. After excretion in the intestine, up to 90% of the bile acids and bile pigments are reabsorbed. This is also called the "enterohepatic cycle".
Another task of the bile secretion is the digestion of fats from food by combining the bile components with fats and fat-soluble vitamins and thus making them receptive and usable for the body.
Gallbladder diseases are often expressed as two main symptoms. On the one hand, the yellowing of the skin, also called jaundice, and pain on the right side of the upper abdomen.
Jaundice is always an indication of a disorder in the bile metabolism. This disorder can have various causes, for example one hepatitis , chronic liver disease , Poisoning or obstruction of the bile drainage, as is the case with Gallstones may be the case. Jaundice is caused by the accumulation of bilirubin in the skin, which accumulates in the body or cannot be excreted.
Timely upper abdominal pain can typically radiate to the right shoulder or right flank. Colic pain can be an indication of gallstones, while persistent pain can be an indication of gallstones Inflammation of the gallbladder (cholecystitis) can indicate.
Benign and malignant tumors of the gallbladder have similar symptoms , however, are treated differently than individually occurring stone diseases and inflammations.
With which diagnosis is a gallbladder operation necessary?
The suspected diagnosis of gallbladder disease can usually be made with typical symptoms of the patient and confirmed by increased laboratory values (bilirubin, LAP, GGT, AP) and ultrasound examinations of the upper abdomen.
The most common and important diagnosis for gallbladder removal is symptomatic gallbladder stones. Acute inflamed gallbladders should be removed because if left untreated they can lead to dangerous complications. Stone-filled and inflamed gall bladders can tear (perforation) or form pus (empyema) and in this way spread to a life-threatening inflammation of the entire abdominal cavity (peritonitis).
Chronically inflamed gallbladders can develop into a so-called porcelain gallbladder, which carries an increased risk of degeneration into a tumor. Gallbladder stones that don't cause symptoms usually don't need treatment. In the case of gallbladder polyps and papillomatoses, too, there is scope for discretion as to when removal is advisable.
Procedure: What happens during the biliary surgery?
Nowadays, laparoscopic cholecystectomy is the standard therapy for symptomatic gallbladder stones and Inflammation of the gallbladder applied. More than 90% of all gallbladder removals can be performed in a minimally invasive manner. The advantages of minimally invasive interventions are:
- Patients complain of less pain after the operation
- There are fewer complications after the operation
- Patients can get back to work more quickly
- Less scarring on the patient's skin.
At the beginning of the procedure, the abdominal cavity is filled with a gas mixture of carbon dioxide and helium, also called pneumoperitoneum. The abdominal cavity is then opened and optical devices and surgical instruments are inserted. To do this, the surgeons usually need four accesses through the abdominal wall.
After the gallbladder has been visited, it is grasped behind the liver and pulled upwards towards the diaphragm. By pulling it up, the so-called Calot triangle is stretched and visible. The Calot triangle describes a landmark in surgery that is formed from the cystic duct, the gallbladder artery and the main bile duct. A severely inflamed gallbladder can make the surgical conditions significantly more difficult.
The cystic duct, from which the bile flows from the gallbladder, is closed with a clip, as is the gallbladder artery. Then the two vessels can be severed and the gallbladder is dissected out of the liver. The gallbladder is then removed from the abdomen and the abdominal wall closed again. Under certain circumstances, drains are also placed from which fluid can subsequently drain off.
Open surgical cholecystectomy
Open surgical removal of the gallbladder is used less and less. The abdomen is opened below the right costal arch and expanded if necessary.
Other surgical steps correspond to the laparoscopic removal. This procedure also has a very low complication rate.
Gallbladder surgery risks and prognosis
Laparoscopic gallbladder removal is very safe with a mortality rate of less than 0.1%. Possible complications of a laparoscopic procedure are missed gallstones in the main bile duct or in the abdominal cavity (residual stones). There is also a risk of injuring structures such as the hepatic artery or bile ducts during the procedure.
Conventional gallbladder removal is also relatively low-risk (0.1%). Possible complications include secondary bleeding, the formation of abscesses or biliary fistulas.
Which doctors are specialists in gallbladder surgery?
Anyone who needs biliary surgery wants the best medical care for themselves. This is why the patient asks himself, where can I find the best clinic for me? Since this question cannot be answered objectively and a serious doctor would never claim that he is the best doctor, one can only rely on the experience of a doctor.
We help you to find an expert for your illness. All listed doctors and clinics have been checked by us for their outstanding specialization in the area of gallbladder removal and are awaiting your inquiry or your treatment request.
Dual series - surgery 4th edition
Netters internal medicine 2nd edition
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