Gallbladder diseases can sometimes have an insidious course. The pain can generally be felt under the right rib, but can also be felt in the middle of the stomach area. Gallbladder stones should especially be considered in back pain.
Patients presenting with gallbladder stones should definitely undergo gallbladder surgery if they show symptoms related to the stone. The gold standard in surgery is the removal of the entire gallbladder by a closed method, called laparoscopic cholecystectomy. There is no stone removal surgery in the treatment of gallstones. The gallbladder is completely removed. However, if there are stones in the bile duct as well as the gallbladder, the stone is first removed endoscopically (ERCP) and then laparoscopic cholecystectomy is performed.
Patients with asymptomatic gallstones must be seen by a general surgeon and personally present. The condition should be evaluated and the decision should be made accordingly.
In addition to routine pre-operative examinations in patients presenting with gallstones, blood tests called cholestasis enzymes, which indicate bile duct obstruction, should also be examined. If these are high, biliary tract evaluation should definitely be performed. Otherwise, if laparoscopic cholecystectomy is performed in the presence of stones or obstruction in the bile duct, the patient may be vulnerable to many postoperative complications. In patients with gallstones presenting with abdominal pain, inflammation of the pancreas, also called pancreatitis, must be excluded before surgery. In some cases, pancreatitis and gallstones may occur together. In these cases, pancreatitis should be treated first and then gallbladder surgery should be performed.
Our patient was taken to gallbladder surgery after all preparations were made. Gallbladder surgery begins with inflating the abdomen with carbon dioxide gas using a thin needle inserted under the belly button. For those who have had previous abdominal surgery, entry is made using the open technique. Having previous abdominal surgery is not an obstacle to laparoscopic cholecystectomy. Then, the surgery is started by using 3 or 4 entrance doors called ports, which allow us to insert laparoscopic instruments into the abdomen and work there. The camera is entered through one hole, and the surgeon's working tools are entered through the other two holes. If the 4th hole is entered, the gallbladder is hung upwards from here and the anatomical plans are image is displayed. First, any adhesions in the gallbladder are removed. These adhesions may be more common in people who experience pain attacks. Then, the gallbladder duct and gallbladder artery are found separately and separated, paying extreme attention to the main bile ducts and the main arteries that feed the liver. Titanium clips are placed in the gallbladder duct (ductus cysticus) and gallbladder artery (cystic artery). In some cases, different clips can be used. After the gallbladder is separated from its artery and duct, the gallbladder is stripped from the liver bed. Finally, the gallbladder is taken out from the incision in a special bag. In cases where the stone is much larger than the incision site, the stone can either be removed by breaking it into pieces in a bag, or the incision can be slightly enlarged.
After gallbladder surgery, patients can be given light foods after 6-8 hours. Under normal circumstances, the patient is discharged 1 day after gallbladder surgery.
Contrary to popular belief, there is generally no need for a special diet after laparoscopic cholecystectomy. Patients lead normal lives after gallbladder surgery. In the early stages, during the adaptation phase of the body, some digestive preparations can be given for a short time.
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