Cholecystectomy

The Gallstone Elimination Report

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Cholecystectomy is the most commonly performed general surgical procedure in the United States. Approximately 600,000 cholecystec-tomies are performed each year, and the number has been increasing with the advent of laparoscopic cholecystectomy. Indications for cholecystectomy include acute and chronic calculous and acalculous cholecystitis, symptomatic gallstones, gallstone pancreatitis, gallbladder polyps, porcelain gallbladder, gallstones in patients with sickle cell disease, and large gallstones (>3cm) [1].

Cholecystectomy was first performed in 1882 and has traditionally been done by the conventional open technique. Laparoscopic chole-cystectomy (LC) was developed in 1987 and has become the surgical procedure of choice, now being employed in over 80% of cases. The advantages of LC over open cholecystectomy include a significant reduction in hospitalization time and recovery period, less pain, and minimal scarring. Overall postoperative complications rates for LC are comparable to those for open cholecystectomy, although there is a slightly higher incidence of biliary injury with LC. Contraindications to LC include peritonitis, sepsis, bowel distention, and advanced pregnancy. Some surgeons would prefer open cholecystectomy in cases of acute cholecystitis, cholangitis, common duct stones, acute pancreatitis, previous upper abdominal surgery, morbid obesity, and portal hypertension [1].

Laparoscopic cholecystectomy is performed under general anesthesia by specialized surgical instruments placed through four trocars placed through the abdominal wall (Fig. 4.1). The surgery is done with visualization of the surgical field on a video monitor.

Complications of laparoscopy in general differ somewhat from those encountered with standard laparotomy and usually occur secondary to trauma from the trocar insertions. These include abdominal wall and omental bleeding, abdominal and retroperitoneal injury, gastrointestinal and bladder perforation, solid visceral injury, and hernias at the trocar incision sites. Rarely, implantation of tumor cells into the abdominal wall at the port sites can occur in patients with unsuspected gallbladder carcinoma [2].

Trocar Laparoscopic Cholecystectomy

Figure 4.1. Intraoperative cholangiogram during laparoscopic cholecystectomy. Supine view of the abdomen at the time of laparoscopic cholecystectomy with contrast medium injected into the biliary tree shows the trocars used for this procedure. A large amount of intraperitoneal air is introduced during surgery.

Figure 4.1. Intraoperative cholangiogram during laparoscopic cholecystectomy. Supine view of the abdomen at the time of laparoscopic cholecystectomy with contrast medium injected into the biliary tree shows the trocars used for this procedure. A large amount of intraperitoneal air is introduced during surgery.

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Get Rid of Gallstones Naturally

Get Rid of Gallstones Naturally

One of the main home remedies that you need to follow to prevent gallstones is a healthy lifestyle. You need to maintain a healthy body weight to prevent gallstones. The following are the best home remedies that will help you to treat and prevent gallstones.

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