[MERGED] Cholelithiasis ( Gallbladder Stones )

[eyedoc]

Please refer to this site: http://www.emedicinehealth.com/articles/10465-6.asp

It really depends on the size of the gallstones and the presence of symptoms. Your doctor will be the best judge of which treatment would be best for you.

[shoe_addict]

Gallstones or Gallbladder treatment? hi i just want to ask anu ok na remedy or method with this case aside from operation? i want to help my cousin.. thanks

[eudemon]

just avoid fatty foods and drink at least 3L of water..

[Phooey]

Sadly the only DEFINITIVE treatment of gallbladder stones (cholelithiasis) and subsequent pain and infection from a stone (cholecystitis) is surgery.
Depending on diferent considerations, a surgeon may opt to do other diagnostic examinations prior to any actual surgery, but keep in mind all diagnostics and procedures are done with surgery in the near future in mind. Quite often the pain may subside, and there is the tendency for the patient to think surgery is unnecessary, but this opens the door for recurrence of the pain and the development of more serious complications later on: Serious infection that can spread to the bloodstream (sepsis) and/or rupture of the gallbladder
What are your cousins concerns? Is he hesitant to go under the surgery because of actual fear of the procedure or because of monetary concerns? He can discuss these with his surgeon and he can even ask for a rough estimate of how much everything will cost (especially if there is little or no medical insurance). If its an uncomplicated case, the surgeon usually presents 2 surgical options, a regular gall bladder removal (cholecystectomy) with a small opening made just below the the border of his/her right rib or a camera-guided (laparoscopic) procedure with several smaller (and less scarring) incisions made near the belly button.
Good luck, and never hesitate to ask you doctors more questions if there are some things you dont feel youve fully understood.

[tintable]

^it depends on the size of the gallstone. some can be treated with oral medications...

[Phooey]

^No. sorry tin, but i have to disagree with you. But before I go into detail about that, let me state the assumptions I made:

1. First of all that the cousin in question was symptomatic (most probably right upper quadrant or epigastric pain), thats why the diagnosis of cholelithiasis/cholecystitis was made through ultrasound.
2. The patient is a good candidate for surgery.

If the 1st and 2nd assumptions I made were correct surgery remains as the only DEFINITIVE treatment. Pain from bile stones is almost always recurrent, so much so that early cholecystectomy is recommended to minimize subequent morbidity and mortality.
(which includes productivity lost due to recurrence of pain, subsequent hospitalizations, and the risk of complications)
To say to a patient that, "we can manage this medically, and surgery either now or in the future is unnecessary" despite medical evidence (from journals and from understanding of the pathophysiology of the disease) on the contrary is the same as lying to that patient.
However if the findings were incidental, for example for some reason the doctor requested a UTZ for another problem and they just happened to see stones in the gallbladder or bile duct and the patient is assymptomatic, you can just choose to observe that patient. Or if, the patient is a poor surgical candidate and any to subject that patient to a surgery now would be more dangerous you can wait till the patient is more stable.

There are several variables to determine the timing of the surgery, the most important of which of course being patient consent and condition. But the surgical end-point/option must always be presented to each patient diagnosed with cholecystitis.


*on a related note, I must really be bored to be posting on this thread so much. sigh.

[tintable]

^didn't know about the patient's details/history and your first post was too long and didn't read it...

i know a few patients who didn't have to undergo surgery even if they were diagnosed to have cholelithiasis

[Phooey]

Ok. I knew my posts were getting too wordy. Just look up some med journals and it will pretty much say the same thing. Those people you know who didnt have surgery now will probably have to in the future. Its just a question of timing.

[shoe_addict]

hi i just want to thank everyone for ur messages..

my cousin found out that she has gallstones 3 months ago. she had an ultra sound and saw 2 stones which i think 2.ocm in size. she doesnt have monetary problem...

shes trying this chinese herbs which sez it can help dissolve the stones for 3 to 6 months.. shes giving it a shot, nothing to lose she said and if it didnt work she would probably go to have operation.

shes worried and scared to have operation because of the SCARS she might get after and the PAIN from the operation hehe... shes a bit maarte with her skin, well i have to agree with her she has nice flawless skin, she probably cant accept to have scars on her belly or rib part...

which of the procedure has lesser SCARS and PAIN? the (cholecystectomy) with a small opening made just below the the border of his/her right rib or a camera-guided (laparoscopic) procedure with several smaller (and less scarring) incisions made near the belly button.

thanks a lot again!

[Phooey]

I think the laparoscopic cholecystectomy is the best option for her, but this is something she could discuss more in-depth with with her surgeon. The majority of Lap cholecystectomies are done under general anesthesia, so she will be asleep throughout the procedure. A certain amount of post-operative pain is common, but for comparisons sake the post-op pain from a liposuction is a lot more severe.
Its a relatively fast procedure, especially for skilled surgeon who has performed the the procedure lots of time.

Heres a brief description of the procedure:

http://www.nlm.nih.gov/medlineplus/e...cle/002930.htm

Of course she's free to try other treatments she feels before she decides to undergo surgery or not. Just tell her to be careful, oftentimes these herbal medications contain unknown components that might be bad for her health. In the meantime she'd best avoid large meals or food that is fatty.

[shoe_addict]

Phooey

thank you so much for all d details.. thanks you so much! my cousin will probably have her operation after her herbal treatment.. take care!

[Abominable]

I underwent a procedure called open cholesystectomy. Ok naman. Wala akong naramdamang pain during and after the operation. I am a bit surprised. Mas masakit pa ang circumcision kesa dun kahit na major operation yun. So wala talagang dapat ikatakot yung mga mag papa opera.

[shoe_addict]

I underwent a procedure called open cholesystectomy. Ok naman. Wala akong naramdamang pain during and after the operation. I am a bit surprised. Mas masakit pa ang circumcision kesa dun kahit na major operation yun. So wala talagang dapat ikatakot yung mga mag papa opera.

really? ist the one who cuts d lower right rib? hows d anesthesia? i herad its really painful, my cousin is a bit scared with that.. where did u have ur operation? were looking for doctor hus really good.. can i ask ur age, coz my cousin is only 25 years old... thnks!

[Abominable]

Hi, I had the operation when I was 19 years old. I had the operation in Capitol Medical Center. I can say the doctors who performed my operation were really good! I did not feel any pain even when they administered the procedure for anesthesia. After the operation, I also did not experience extreme pain, although there is some manageable slight discomfort.

[tintable]

^^^good pain management helps to relieve post-op discomfort through proper medication, breathing, ambulation and movement techniques.

lap chole may be a good option for those who do not want some major scarring or for those who have extra cash to spend.

[chiNee0210]

Good Day Doc;

Nadiagnosed po ang mother ko na may bato sa apdo. Magkano po kaya ang laparoscopic cholecystectomy procedure at saan po ba ang mas mura pero dekalidad na hospital at doctors. Di po kami mayaman. Nagbabakasakli lang po makahanap ng mas mura.

Another question, kailangan po ba na magundergo ng super mega laboratory ang pasyente bago ang operation?

And # ko po ay 09163618091. Please po...Namimilipit po sa sakit ang mother ko pag sinusumpong ng panghihilab ng tyan. Gusto ko na po sana siya maoperahan.
Nagpapasalamat...

Migo

[ferkhite]

I prsonally underwent Laparascopy ok naman siya ...maliit lang tahi sa skin 1 inch lang pero 4 di naman ganu halata ok naman ako kahit wala abdo hehehe....pero mejo mahal nga lang siya.....

[Pickheart]

Ano ba possible complications nito?

May multiple gall bladder stones (mga around 9mm daw ang diameter each) kasi dad ko. Pag nag-undergo daw sya ng surgery... yung gall bladder daw eh tatanggalin. I'm wondering kung bakit di na lang yung mga gall bladder stones ang tanggalin & bakit kelangan pang pati yung gall bladder mismo.

[K_r_a_m]

Many complications can occur such as cholangitis and sepsis. Surgeons cannot just remove the stones because of the possibility of the stones to recur. And in your father's case, having multiple stones, removal of the gall bladder is very necessary. Your father has an option to either choose an open cholecystectomy, wherein surgeons remove the gall bladder by opening the abdomen, or he can choose to have a laparoscopic cholecystectomy done, wherein the patient would have only 4 small scars on his abdomen. It is best to consult his surgeon to find out which procedure is best for your dad. Hope this helps.

[drquack]

Ano ba possible complications nito?

May multiple gall bladder stones (mga around 9mm daw ang diameter each) kasi dad ko. Pag nag-undergo daw sya ng surgery... yung gall bladder daw eh tatanggalin. I'm wondering kung bakit di na lang yung mga gall bladder stones ang tanggalin & bakit kelangan pang pati yung gall bladder mismo.

If he's symptomatic, surgery is advisable especially if you said that he works on a ship and may not have access to immediate medical services while out at sea. Removal of the gallbladder is necessary because previous episodes of inflammation of the gallbladder leads to scarring. With scarring, the gallbladder can't efficiently contract, and stones are bound to recur. Complications, anywhere from recurrent bouts of pain to a severe systemic infection leading to death in the extreme end. Recovery period, depends. For open chole, he can be up on his feet by 3-4 days BUT for heavy labor, 2-3 months. It takes a full 6 mos. to get back to his pre-op condition. For lap, that's a different story. A week or two would do it.


DaVinci, incision naman, di naman laceration. hehehe. A laceration is an irregularly shaped wound caused by an irregularly shaped object, say a jagged piece of metal or a broken bottle.