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Gallstones

Gallstones

GALLSTONES:

Gallstones are stone-like objects that form in the gallbladder or bile ducts. Gallstones can be tiny (the size of a grain of sand), or may be as large as a golf ball. Depending on the symptoms, people who have gallstones may not need treatment, or they may need to take medication or have surgery to remove their gallbladder. If the stones are in the bile ducts, they usually need to be removed by endoscopy.

DIAGNOSIS OF GALLSTONES:

Ultrasound abdomen: is a procedure that transmits high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photographic images of the internal structures of the body.

Other tests that may help in the diagnosis of gallstones include the following:

Computed tomography (CAT scan)

Endoscopic retrograde cholangiopancreatography (ERCP): In this test, an endoscope—a flexible tube with a light and a camera attached—is inserted into the patient’s mouth, down the throat, and into the stomach and small intestine. A dye is injected to allow the bile ducts to stand out. If there are gallstones in the bile duct, they can be removed by the endoscope.

Magnetic resonance cholangiopancreatography (MRCP): In MRCP, the bile ducts are examined with magnetic resonance imaging (MRI), a test that uses a large magnet, radio waves, and a computer to produce very clear images of parts of the body. Unlike ERCP, MRCP can only diagnose gallstones; it cannot be used to treat gallstones.

Endoscopic ultrasound (EUS): This procedure combines endoscopy with ultrasound. In EUS, a small ultrasound transducer is installed on the tip of an endoscope and inserted into the patient’s mouth. Because the EUS transducer can get close to the gallbladder and bile ducts, the images obtained with EUS can be more accurate and detailed than images provided by traditional ultrasound.

TREATMENT OF GALLSTONES:

In most cases, if you have gallstones in the gallbladder but no symptoms (silent stones), you probably do not need treatment.

If you have symptoms such as pain, you will probably need to be treated. The treatment that is used most often for gallstones is surgery to remove the gallbladder, which is known as a cholecystectomy. In the vast majority (90%) of cases, this surgery is performed laparoscopically.

Laparoscopic cholecystectomy is known as a “minimally invasive” procedure because it uses several small incisions instead of one large one. A laparoscope, a narrow tube with a camera, is inserted through one incision. The camera allows your doctor to see your gallbladder on a TV screen. Your gallbladder is then removed through another small incision.

If the patient has certain complications associated with gallstones – such as inflammation, infection, major scarring from a previous surgery, a bleeding disorder, or a condition that would make it difficult to see through the laparoscope – the surgeon may have to remove the gallbladder with an open cholecystectomy through an incision in the abdomen.This procedure requires a longer hospital stay (3-5 days).

If there are gallstones in the bile duct, they need to be removed in most cases even if you do not have any symptoms. This is done most commonly with the endoscopic retrograde cholangiopancreatography (ERCP) procedure.

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