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The mission of NorthStar Surgery Specialists, P.A. is dedicated to promoting health care by providing excellent emergency service and elective general surgery service to the Austin metro and surrounding areas.
The gallbladder stores bile, which is produced by the liver and carried to the gallbladder and duodenum through the bile ducts. This is used to digest animal and vegetable fats, or highly spiced foods. Then, depending on the characteristics of the food, the stomach sends a signal to the gallbladder to contract and empty, so bile mixes with food and the person can digest well.
According to the American Gastroenterological Association, “[g]allstones are pieces of hard, solid matter that form in the gallbladder. They form when the components of bile — including cholesterol and bilirubin — form crystals. Gallstones may be as small as a grain of sand or as large as a golf ball, and the gallbladder may contain anywhere from one stone to hundreds. Gallstone disease is a common medical problem, affecting 10 to 15 percent of the population of the U.S., or well over 25 million people. Nearly 1 million new cases of gallstone disease are diagnosed every year in this country, approximately one-quarter of which require treatment.”
Gallstones. (2018). Retrieved from http://www.gastro.org/patient-care/conditions-diseases/gallstones
How can the patient know if he/she has gallbladder stones?
Pain in the affected area.
Yellow pigmentation of the skin and eyes (jaundice).
If the patient has any of these symptoms, he or she should seek medical attention urgently, since these symptoms can trigger dangerous diseases, such as pancreatitis (inflammation of the pancreas) and cholangitis (infection/inflammation of the bile duct).
Gallbladder Case Study
The experience that I had with the procedure was very little pain, just small incisions, it didn’t really bother me that much. He (Dr. Choudhry) gave me prescriptions for the pain, I didn’t take one of them because it didn’t come up..Ben Tangel
What can the patient do to reduce the risk of gallstones?
Maintain a Body Mass Index between 18.5 and 25.
Eat a diet low in fat, cholesterol, but high in fiber.
Avoid rapid weight loss in a short period of time.
Monitor blood sugar levels and maintain them stable.
Avoid certain medications used to lower cholesterol levels.
Avoid medications that have a high estrogen level.
Avoid long-term liver damage.
Eat more organic foods.
Avoid fasting or skipping meals.
While certain medications can increase the risk of getting gallstones, the patient should not stop taking them prior to his/her doctor approval.
How can the physician determine if the patient has gallstones?
Taking into account the patient’s clinical history, the treating physician carries out a series of medicals exams on the patient to confirm the diagnosis of this disease, such as an ultrasound and/or a computed tomography (CT). Then, several treatment options are proposed, such as open surgery, laparoscopic surgery, and robotic surgery.
How can the patient prepare for gallbladder surgery?
The preoperative preparation includes blood tests, medical evaluation, and an EKG according to the patient’s age and medical condition. Medications such as anticoagulants, anti-inflammatory medications (arthritis medications), and vitamin E may need to be temporarily suspended for several days to weeks before surgery. Dietary medications should not be used two weeks prior to the procedure. The patient must stop smoking and request at home assistance. After midnight of the night prior to the operation, the patient should not eat or drink anything. The patient can take medications that he/she is allowed to take under his/her gallbladder surgeon’s authorization with just a sip of water.
Gallbladder Surgery Texas
Vineet Choudhry, MD FACS is a specialized gallbladder surgeon in Texas, who offers his patients minimally invasive treatment choices.
Cholecystectomy is one of the most frequent surgeries in the United States; every year there are more than 700,000 surgical treatments and approximately more than 300,000 cases of gallstones. This type of disease has multiple risk factors such as age, weight, gender, parity, diabetes, and genetics.
Through robotic surgery, difficult surgery maneuvers can get more precise. Since this system has a third dimension vision system, there is also a better appreciation of the area’s important structures.
It is a surgical procedure in which the abdomen is opened to allow a gallbladder removal. This operation has been used for more than a century and is a safe and effective method to treat symptomatic gallstones. This type of surgery allows direct visualization and palpation of the gallbladder, bile duct, cystic duct and blood vessels. Any major complications of open cholecystectomy are infrequent but could include damage to the ducts, hemorrhage, biloma, and common infections.
It is a keyhole technique that is used to remove stones from the inside of the bile duct by passing baskets and other instruments to the bile duct and catching the stones with the help of an X-ray.
It is used for cases where the stones in the duct are large, impacted or cannot be removed by other methods. It is an open operation involving a 6-10 inches incision, on the upper right side of the abdomen below the rib cage to allow access to the bile duct.
What to Expect After Gallbladder Surgery?
Gallbladder Removal Surgery
After gallbladder removal surgery, bile flows from the liver (where it occurs) through the common bile duct and into the small intestine. Because the gallbladder is gone, bile is no longer stored between meals. In most people, this has to no effect on digestion.
Depending on the surgical treatment, in case of robotic or laparoscopic surgery, the patient must rest between 3 and 4 weeks; if it requires doing activities that require physical effort, from 2 to 3 months, and if a patient opts for an open cholecystectomy, he/she can resume light activities after 4 to 6 weeks and make a more strenuous physical effort after 8 to 12 weeks.
Although gallbladder laparoscopic removal of the gallbladder has many advantages (cholecystectomy), the procedure may not be appropriate for some patients who have severe gallbladder disease or a previous upper abdomen surgery. A thorough medical evaluation by the physician with a consultation with a trained laparoscopy surgeon can determine if laparoscopic removal of the gallbladder (cholecystectomy) is an appropriate procedure for the patient.
Vineet Choudhry was born near Chicago and has lived in various places growing up such as Kansas City and San Francisco. However, he moved to Ft. Worth, Texas in 1984 and now considers himself a native Texan. He graduated with a Bachelor of Science in Biochemistry from the University of Texas at Austin in 1997. He then received his medical degree at Texas A&M Health Science Center College of Medicine. After successfully completing his specialty training residency in General Surgery at the University of Kansas School of Medicine in Wichita, Kansas, he returned to Austin in 2008 to open his medical practice. Over the years since then, he has among other things specialized in the care and treatment of breast disease.
Learn more about Vineet Choudhry by visiting NorthStar Surgery Specialists Website.