Removing stones from the gallbladder: modern techniques

Causes of the disease

The gallbladder is a sac organ that serves as a container for bile, which is constantly produced by liver cells.

Gallstone disease (cholelithiasis) causes the formation of stones in the ducts and bladder due to a malfunction in the body's metabolic processes.

The disease occurs gradually, without manifesting itself, for many years, until a critical mass of stones accumulates in the organ and ducts.

Such stones vary in composition, size and shape. They have the ability to irritate the walls of the bladder, causing inflammation (cholecystitis). The basis for the formation of pathological formations are calcium salts or cholesterol crystals.

When a stone comes out of the bladder and the bile duct is blocked, severe pain, or biliary colic, appears.

The gallbladder is for the bile that the liver secretes. It is simply necessary for normal and complete digestion of food. The substance consists of many components, among which two main ones are worth highlighting: bilirubin and cholesterol. As for the latter, with its high concentration, improper outflow and stagnation, the formation of stones occurs. No exception is infection of the bladder.

If bile stagnates in the bladder for a long time, it begins to settle. The sediment gradually turns into microscopic sand. Further subsidence ends with the formation of stones.

Stones come in different sizes. Small formations up to 2 mm can pass into the ducts without obstacles. But large elements are retained inside the bladder, which causes the appearance of signs of gallstone disease. If not treated promptly, the stones will grow until they occupy the entire cavity. Doctors separately talk about the danger of stones in the bile ducts.

Often the pathology occurs without pronounced symptoms, which significantly complicates diagnosis in the initial stages. An exacerbation occurs when the pathological process is started. This forces doctors to use emergency treatment methods. Obvious manifestations of cholelithiasis are:

• nausea;
• vomit;
• hepatic colic;
• bloating;
• pain in the liver area;
• yellowness of the skin and eyes;
• temperature increase.

If treatment is not started for a long time, the ducts become narrowed, the organ becomes infected and a focus of inflammation develops.

Many doctors recommend sticking to a diet. Its main condition is to reduce to a minimum the consumption of foods rich in oxalates (meat, chocolate, nuts, black pepper, leafy green vegetables). Urologists recommend the following as preventive measures:

1. To live an active lifestyle.
2. Undergo regular preventive examinations.
3. Limit the consumption of fatty, spicy, smoked and sour foods.
4. Eat often, but in small portions.
5. Fight excess weight.

Pathology in recovered patients may recur. Therefore, they need to take seriously the advice to drink plenty of water every day.

Today, urolithiasis is a common problem. Thanks to modern surgical treatment technologies, it is possible to effectively combat pathology. Unfortunately, the latest medical developments are not available to everyone due to their high cost.

Removing stones using medications

Only cholesterol stones with a diameter of up to 2 cm are amenable to medicinal breakdown. Special preparations do not affect pigment or calcareous stones in the bladder.

To dissolve bile deposits, the following are used:

• Henochol;
• Ursosan;
• Ursodex;
• Ursofalk;
• Choludexan.

To remove dissolved choleliths, take medications that stimulate bladder motility - Lyobil, Allohol, Artichol. Medical removal of stones is contraindicated if you are pregnant, have a duodenal ulcer, have kidney failure, or are obese.

Treatment options

Urolithiasis (urolithiasis) is a serious pathology widespread throughout the world, in which, due to metabolic disorders that occur for certain reasons, sand and stones are formed in the kidneys and urinary tract, which creates a life-threatening condition for the patient.

These include:

• renal failure;
• progressive pyelonephritis;
• obstruction of the lumen of the ureter, etc.

Treatment of urolithiasis is aimed at determining the causes of the disease, eliminating the main symptoms and taking preventive measures to avoid relapse of the disease in the future.

Depending on the severity of the disease, various approaches are used in the treatment of urolithiasis:

• conservative methods;
• diet therapy;
• minimally invasive (gentle) methods;
• open surgical operations.

Conservative treatment in most cases when removing stones from the urinary system does not give positive results. Following a properly prescribed diet and a healthy lifestyle will help minimize the risk of kidney stones in the future.

Recently, minimally invasive operations that are performed using gentle methods have become very popular. Kidney stones are destroyed and removed using modern equipment through natural channels or small punctures.

These operations require special training of doctors and technically sophisticated equipment.

The following common minimally invasive methods of treating urolithiasis can be mentioned:

• laparoscopy;
• lithotripsy.

During laparoscopy, small incisions are made in the skin in the lumbar region, through which special instruments with a diameter of no more than 10 mm and a video camera are inserted into the desired kidney. All actions of the surgeon are displayed on the computer monitor. A large stone found in the kidney is destroyed by a laser, ultrasonic waves or special instruments and removed piece by piece. A small stone is removed without prior destruction. To improve healing, drainage is installed in the kidney.

Endoscopic equipment for removing stones from the bladder, ureter, and urinary tract is inserted through the opening of the urethra.

These methods of removing stones from the urinary system are preferable due to the small blood loss during the operation, gentle effect on surrounding tissues, short recovery period, and absence of cosmetic defects.

Lithotripsy is one of the newest methods of crushing and removing small stones from the kidneys without damaging the patient's skin.

There are contact and distance lithotripsy. With the contact method of treatment, a thin endoscope with a video camera is inserted into the kidney through the urethra, bladder and ureter. Depending on the structure of the stone, it is crushed in various ways: laser, ultrasound or pneumatic pulses. The stone crushed into fragments is removed outside on its own, naturally.

With external lithotripsy, kidney stones are crushed using targeted ultrasound radiation without harm to surrounding tissues.

Conservative methods can be used, but drug treatment is symptomatic. The source of the problem will not go away. The basis for a radical cure for urolithiasis is surgery. Complex abdominal operations, with a long preparation and rehabilitation time, are already a thing of the past. The treatment method in the twenty-first century is lithotripsy.

Let's talk about it in more detail.

Lithotripsy is an operation to destroy kidney stones and then remove them. It is completely non-invasive, i.e. bloodless or minimally invasive procedure. Its essence is to remove stones using a shock wave using ultrasound or laser energy using various techniques:

• remote;
• through a urethral endoscope;
• through the skin.

Stones in the ureter and kidneys
Which method to choose is determined by the doctor together with the patient. First, a general diagnosis is carried out: they take urine, stool, general and biochemical blood tests, tests for hepatitis, HIV and syphilis, and do an ECG. After this, the type of stones is determined, for example, urate, oxalate, etc., and their size. Assess the general condition of the patient and identify the presence of concomitant diseases.

Cholelithiasis of the gallbladder

Early diagnosis of the disease provides the opportunity to carry out the procedure in a gentle way. Many patients prefer to continue living with stones with an appropriate diet. But in selected patients, an acute manifestation of the disease occurs with attacks of biliary colic. In a difficult situation, surgical intervention will be required to remove the organ, depending on the patient’s condition and the stage of development of the disease. Non-surgical stone removal allows you to keep the organ in a relatively stable condition. Methods used:

• splitting stones with special medications;
• extracorporeal lithotripsy;
• laser crushing of stones;
• removal of stones using ultrasound;
• laparoscopy;
• cholecystectomy.

The last two points imply an operation to remove the gallbladder along with the stones. The rest allow you to do without surgery.

The development of cholelithiasis largely depends on the rate of stone formation and stone mobility. Without appropriate treatment, the disease in most cases leads to complications that significantly worsen the patient’s quality of life. Removal of stones from the bile ducts and bladder can be carried out using shock wave or laser lithotripsy (stone crushing using ultrasonic waves, a laser beam), but the effectiveness of this method is low (about 25%) and its feasibility is limited by a number of conditions.

Cholelithiasis

Cholelithiasis (Cholelithiasis) is a chronic disease with a hereditary predisposition to the formation of stones in the biliary tract. One of the most common problems in the world. The cause of the disease is an increased concentration of bile.

What determines the risk of developing cholelithiasis?

Bile

Main factors:

• age (the maximum frequency of symptoms of the disease is observed at the age of 40-70 years);
• gender (cholelithiasis develops more often in women, which is associated with the influence of estrogens on the formation of bile);
• pregnancy (the risk of stone formation increases with each subsequent pregnancy, but there are known cases of spontaneous dissolution of formations after childbirth);
• hormone replacement therapy for menopause;
• taking estrogen;
• obesity;
• lipid metabolism disorders;
• burdened heredity;
• rapid weight loss;
• diabetes;
• long-term parenteral nutrition (complete);
• abuse of fatty foods;
• cirrhosis of the liver.

Craving fast food can end badly

Recently, there has been an increase in cholelithiasis among adolescents and children.

Indications for gallbladder removal

There are two ways to treat pathology:

• conservative;
• surgical.

The conservative method involves:

• changing the patient’s lifestyle, giving up bad habits;
• establishing a diet;
• frequent split meals;
• drinking control.

To reduce the formation of gallstones and dissolve existing ones, therapy with drugs that contain ursodeoxycholic and chenodeoxycholic acids is used.

Treatment is long-term and indicated only for small cholesterol stones. The method is not effective enough, so in 80% of patients the reappearance of stones was noted after 18-24 months.

The surgical method is the most optimal, since in this case the gallbladder is eliminated as an object of pathology.

Doctors usually recommend gallbladder removal if:

• formations in the bile duct;
• stones in the bladder itself;
• aggravation of cholelithiasis by inflammation of the organ;
• diagnosed pancreatitis.

to prevent possible complications that are life-threatening for the patient.

• development of acute inflammation of the gallbladder;
• blocking of bile excretion pathways with stones, development of inflammation of the organ and pancreas;
• rupture of the bladder, development of peritonitis;
• intestinal obstruction due to the loss of stones from the bladder and ducts.
• possible development of neoplasms in the gallbladder.

The type of surgical intervention (removal of the gallbladder or just stones) is chosen by the doctor. This is done after a thorough examination of the patient, studying the composition of the stones and the severity of the condition.

An operation to crush kidney stones using ultrasound and an endoscope is indicated in the following cases:

• stones from 0.5 cm;
• severe pain syndrome;
• ineffectiveness of conservative therapy;
• The composition of the stone allows ultrasonic crushing and removal.

Like any other medical procedure, lithotripsy has limitations and contraindications:

• overweight and tall, although some modern devices do not have such restrictions;
• pregnancy;
• high density and very large size of stones;
• some common diseases;
• inflammatory diseases of the genitourinary system.

In addition, before the procedure, the anesthesiologist is obliged to find out whether the patient has intolerance to anesthesia. In this case, a large person may be offered remote destruction of stones without anesthesia.

The formation of hard stones of different sizes in the gall bladder is a fairly common pathology.

Is it effective to crush gallstones?

The effect is considered effective if there is no relapse within a year, and ultrasound 6 and 12 months after the procedure shows that the gallbladder is free of stones.
If the patient, after crushing the stones, takes ursodeoxycholic acid, which has a litholytic effect, then the effectiveness can reach 80%, at least 45%. At its core, this method is symptomatic, and not etiotropic (eliminating the cause of the disease) treatment. Therefore, it does not prevent the reappearance of stones. Most often it is used to break up stones stuck in the duct after removal of the bladder. But only if for some reason it is impossible to perform endoscopic lithoextraction: for example, there are contraindications or other obstacles to the operation.

Crushing with medicines

Nowadays, cholelithiasis is very common. Several methods are used to treat it.

First, therapy begins with conservative methods and only in case of ineffectiveness, surgical intervention is used.

After medications have not given the desired result, specialists may prescribe crushing of gallstones.

Gallstone disease, in which calculi (stones) form in the cavity of the gallbladder, is a very common disease.

Alas, its effective treatment is often only possible through surgery, in which this organ has to be removed. However, the main task of doctors has always been and remains to do everything possible to avoid surgical intervention.

Crushing or dissolving stones in this internal organ are techniques that, in some cases, can cure the disease without surgery.

Cholesterol gallstones

Modern medicine has in its arsenal several methods of non-surgical treatment of this pathology.

These include:

• drug therapy;
• shock wave lithotripsy;
• crushing stones using a laser.

Before we look at the existing methods of conservative treatment of this pathology, let's figure out where gallstones come from and what factors influence the development of this disease.

The formation of gallstones is considered a fairly common disease. Diagnosing the disease is difficult; examination, including ultrasound, is required; often the patient is unaware of the development of the pathology; the disease rarely manifests itself. Sometimes a person lives with formed gallstones for several years. Perhaps all my life.

The reasons for the formation are varied: excessive consumption of foods rich in cholesterol, excess body weight, heredity, provoking established diseases of the digestive system or complications, bad habits, psychological stress.

Removing stones from the gallbladder using ultrasound is considered a completely painless method. Shows a high percentage in a positive outcome. The meaning of the method is to use special equipment that, through the direction of vibration and a shock wave, can break the stones into small pieces that are excreted naturally through the intestines. For the effectiveness of the procedure, the use of special drugs is added. A number of conditions for using the method must be observed:

1. If no more than 4 stones are found;
2. Lack of pregnancy;
3. Stone no more than 3 cm without lime particles;
4. Availability of special equipment;
5. No chronic diseases of the digestive system.

A big plus is the minimal mechanical impact.

Crushing with drugs is used in case of detection of stones whose diameter does not exceed 2 cm. Here, medications are prescribed that correspond to bile acids and agents that stimulate the production of bile and contraction of the organ. Before starting therapy, the doctor checks whether the patient has the following contraindications:

• concomitant diseases of the kidneys and gastrointestinal tract;
• taking contraceptives that contain estrogens;
• moderate and severe obesity;
• pregnancy and lactation.

It should be borne in mind that the drug method has disadvantages:

• increases cholesterol, which leads to relapse of cholelithiasis;
• varies in duration - from six months to several years;
• has side effects such as diarrhea and others.

Due to the high price of drugs and the long course of treatment, this technique is not popular among patients and doctors.

The essence of the technique is the use of a shock wave, which produces vibration and high pressure. Under this influence, the formations are crushed. As a result of crushing, small stones remain, which are removed through the ducts. The method is indicated for patients who have small formations, the diameter of which does not exceed 3 cm. Moreover, their composition should not contain lime impurities.

Before crushing stones, it is worth considering the fact that such a procedure has a number of contraindications:

• poor blood clotting;
• chronic gastrointestinal pathologies;
• pregnancy;
• lactation period.

As a result of ultrasonic fragmentation, the patient may experience complications in the form of duct blocking and damage to the gallbladder from sharp fragments. Therefore, before prescribing crushing, the doctor evaluates all possible risks.

Causes and mechanism of stone formation in this organ

Hepatocytes (liver cells) produce such an important digestive secretion as bile around the clock. Since this liquid is very aggressive, before entering the intestines it accumulates in the gallbladder, where it acquires the necessary consistency. When food enters the gastrointestinal tract, it enters the duodenum through the bile duct system and helps break down the food bolus (especially heavy fats of animal origin).

The composition of bile mainly includes:

1. cholesterol;
2. special types of bile acids;
3. special pigment (bilirubin);
4. phospholipids;
5. water.

It also contains calcium compounds, some types of vitamins and other enzymes in small quantities.

Since neither cholesterol nor bilirubin dissolve in water, their uniform distribution in bile is possible only in the form of compounds with other components.

For example, cholesterol, in combination with phospholipids and bile acids, is distributed in this liver secretion in the form of bile micelles, and bilirubin bound to proteins forms its own special compounds.

The main causes of stone formation in this internal organ are impaired metabolic processes and stagnation of bile. When stagnation occurs, cholesterol and bilirubin compounds break down, as a result of which these substances begin to precipitate and form crystals (the so-called biliary sludge), which form stones over time.

These stones are classified according to the criterion of the substance that forms their basis. Based on this feature, gallstones are divided into:

• cholesterol (cholesterol-based stones);
• pigment (based on bilirubin);
• mixed (such stones contain cholesterol, bilirubin and calcium compounds).

Only cholesterol-based stones are amenable to drug therapy. Mixed stones, alas, cannot be dissolved by anything.

The main method for diagnosing this disease is ultrasound - ultrasound examination of the gallbladder. This diagnostic technique allows not only to detect the presence of stones in the bladder cavity, but also to determine their size, number and location, and also to determine the presence of a concomitant inflammatory process by thickening the walls of the organ.

Removing stones from the gallbladder: ultrasound or laser, consequences

A new method of non-surgical intervention. Laser removal of gallstones is a little similar to the previous method. Called lithotripsy. In this case, the stones are impacted by a laser beam, crushing them to the state of sand, which is removed from the body independently.

Removing stones from the gallbladder with a laser allows you to use the instrument without the possibility of performing surgical intervention due to the patient’s health condition. The process takes little time, preserving the organ. Rules to be followed:

1. stones no larger than 3 cm in size;
2. the permissible quantity for crushing stones with a laser is 3 pieces;
3. the patient's body weight does not exceed 120 kg;
4. general health without concern;
5. age up to 60 years;
6. availability of special equipment and a qualified doctor.

Removing gallstones with a laser is a quick and painless method. To achieve better results, medications are prescribed.

A puncture is made on the anterior wall of the peritoneum, which allows the laser to reach the desired point. It is fed directly into the gallbladder, where the stones are crushed. The advantages of the method include speed. So, the procedure takes no more than 20 minutes. There are contraindications to laser crushing:

• obesity (weight more than 120 kg);
• old age of the patient;
• serious condition of the patient.

The disadvantage of using a laser is that it sometimes causes burns to the mucous membrane. Subsequently, an ulcer forms at this site. Sharp debris can damage the walls of the bladder. In addition, the procedure requires special equipment.

Disadvantages and consequences of the procedure

Despite the gentle effect of lithotripsy, stone removal cannot always be carried out without consequences:

• the slightest deviation of the beam during surgery causes severe burns to the walls of the gallbladder;
• when the laser is applied repeatedly to the burn site, neighboring organs are damaged and perforations are formed;
• crushed stones, when released, injure the walls of the gallbladder;
• It is possible that stones may become stuck in the bile duct; emergency surgery may be required.

The patient needs to be aware of the possible dangers of such treatment. He must make the decision to agree to the operation independently, since he will have to overcome the complications personally.

Removing stones does not affect the cause of their formation. For treatment to be successful, the patient will need to adjust the diet to prevent the re-formation of deposits in the bladder. Neglect of simple recommendations gives rise to a high probability of relapse and again brings the patient to the operating table, where he may face removal of the organ. Treatment in this case will be longer and more expensive.

Removing stones from the gallbladder with a laser is one of the progressive techniques that allows you to crush gallstones and remove them from the body without resorting to traumatic abdominal surgery. In case of cholelithiasis, doctors try to preserve the organ and its functions as much as possible, and the use of laser successfully solves this problem.

Removal of kidney stones: indications, types of surgery, postoperative period

The postoperative period after laparoscopic organ removal lasts up to 21 days (with traditional surgery - up to 60 days).

The patient’s recovery process is a complex process, including:

• determining the daily routine;
• diet and nutrition plan;
• drug therapy;
• physiotherapy and exercise therapy.

Patients' complaints after surgery do not differ from complaints during other surgical interventions. Typically patients note:

• pain when urinating;
• increased body temperature;
• slight bleeding in the area of ​​the surgical field;
• general weakness and malaise.

Preparing for surgery

Both laparotomic and laparoscopic stone removal require preliminary measures. A few days before the procedure, the following are taken:

• General blood and urine analysis.
• Biochemistry.
• Kshs (acid-base state) and electrolytes.
• Coagulogram.

In addition, a repeat ultrasound examination of the gallbladder and other abdominal organs is prescribed. After consultation with a therapist, anticoagulants and antiplatelet agents (Heparin, Aspirin) are discontinued. This reduces the risk of bleeding.

On the eve of delivery to the operating room, the patient is given a cleansing enema , it is recommended to shave the pubis and abdomen, remove dentures, contact lenses, and jewelry. All this can interfere with the work of an anesthesiologist or surgeon. If necessary, sedatives are administered to help the person get enough sleep.

In the anesthesia room, the patient's legs are wrapped in elastic bandages, a peripheral or central venous catheter is placed, and preliminary anesthesia (Thiopental, Propofol) is administered. After this, the doctor intubates the patient and connects him to a ventilator and cardiac monitor. The prepared patient is delivered to the operating room and the procedure begins.

Laparotomy is a classic intervention in which access is provided through a wide incision. Laparoscopy is a method of minimally invasive bladder extraction in which the surgeon works through small punctures in the abdominal wall.

Chemical cholelitholysis

The technique is used to dissolve various formations. It is suitable for any occasion and can crush even large gallstones. The method is widely used for cholelithiasis at any stage. In this case, the symptoms of the pathology are not important. Treatment is carried out even with an acute clinical picture.

The principle of the procedure is simple. Under ultrasound guidance, small catheters are inserted into the patient's organ. Through it, a special agent is supplied that dissolves the stones. The advantage of the technique is its high efficiency.

What rocks can be broken?

Cholesterol stones, in which alcohol is the main component, are treated without surgery. Treatment happens:

• conservative (with the help of medications);
• surgical (removal of the bladder using cholecystectomy).

The third group includes lithotripsy. Sometimes an unusual thing happens: along with vomiting, stones come out through the mouth. This means the formation of a fistula, it is necessary to prepare for the operation, preventing infection. It happens that a large stone clogs the intestines.

Conservative methods are based on the dissolution of cholesterol with bile acids. The stone gradually melts and in a couple of years can disappear completely. They drink herbs and special preparations consisting of bile acids. A wide range of limitations have been identified for lithotripsy.

Possible complications

Surgery to crush kidney stones is a painful and difficult procedure. There are usually no complications after surgery. Subject to highly qualified doctors, good equipment, attentive care, and compliance by the patient with the doctor’s instructions.

Otherwise the following are possible:

• kidney hematoma;
• pyelonephritis;
• urethral obstruction;
• arrhythmia;
• increased blood pressure;
• pneumonia;
• inflammatory diseases of the urinary organs and tracts.

We have found that crushing kidney stones is carried out in various ways. They all have both advantages and disadvantages. Your attending physician will help you choose the optimal type of lithotripsy. Do not delay the operation to avoid serious complications.

Be healthy!

Removing the gallbladder eliminates the source of inflammation in the body, but does not change the metabolism. The threat of recurrence of stones is not eliminated.

After intervention, the human body faces a whole range of problems.

• pain in the hypochondrium;
• inflammation of the duodenum and pancreas;
• changes in the diameter of the bile duct (as a trauma after surgery).

Inflammation of the duodenum occurs due to a decrease in the volume of bile and its composition after surgery. Normally, bile, released from the gallbladder in sufficient volume, disinfects the intestines.

Removing the gallbladder is a fairly common surgical procedure. The technique is becoming more perfect and safer for patients.

By adhering to a diet, giving up bad habits, and establishing a daily routine with sufficient physical activity, the patient can lead a normal, fulfilling life.

Crushing stones using unconventional methods

Many patients are concerned about the question of whether it is possible to remove stones without surgery and medications. It turns out that in the initial stages the use of herbal decoctions showed high effectiveness. They allow you to crush formations formed from cholesterol crystals and calcium salts.

Traditional methods are effective only for stones up to 2.5 centimeters in size. Larger formations can clog the ducts and worsen the overall picture of the disease. Herbs such as goldenrod, stinging nettle, motherwort, celandine, dandelion, sweet clover are known to have a crushing and splitting effect. The most effective are decoctions of several herbs.

It is important to understand that herbs do not provoke a sharp outflow of bile from the body. They act softly. The stone gradually crushes and splits into sandy grains. After this, they are excreted through the bile ducts. This process takes a long time.

In addition to herbal decoctions, vegetable juices have a crushing effect. Experts noted that carrot juice gives good results. Beetroot, cucumber, parsley and celery. They are used separately or in mixture. For a therapeutic effect, you should drink at least 1–2 liters of juice per day in several approaches. The effect of vegetable juices is due to the presence of acids that dissolve and remove stones from the body:

• Recipe based on Motherwort. For preparation you will need a mixture of motherwort, goldenrod and stinging nettle herbs in equal parts. For 200 ml of boiling water, 12 tablespoons of each herb are required. The mixture is brought to a boil and left for 15 minutes. The decoction is taken half an hour before meals. Removal of stones from the gallbladder occurs within a month.
• Herbal mixture recipe. For cooking you will need 5 tsp. Celandine, Sweet clover and Wormwood flowers, 3 tsp each. Dandelion leaves, Chicory root, Valerian, Gentian. The herbs are mixed well. For the decoction, use 1 tablespoon of the mixture per glass of boiling water. It is recommended to leave the broth for at least an hour. Take the medicine 2 times a day, 50 ml. The course of treatment is at least 2 months.
• A mixture of beet juice, carrots and cucumber. For preparation, use 70 ml of carrot and 30 ml of beet and cucumber juices. During the day, drink 3-4 vegetable cocktails. It is advisable to distribute the intake time evenly.
• Celery juice with parsley. For the cocktail, use 100 ml of carrot juice, 50 ml of celery juice and 20 ml of parsley juice.

In cases where drug treatment did not produce results, and after crushing the stones reappeared and are accompanied by severe pain, removal of the gallbladder is indicated. The method of surgical intervention is determined by the attending physician.

Laparoscopy of the gallbladder and removal of stones: the course of the operation and diet

In the human body, each organ must perform a specific function, which affects the general condition. The gallbladder is part of the digestive system; it is located under the liver and stores the bile produced by it. Often, if there are problems with its functioning, doctors suggest complete removal of the organ. This operation is called laparoscopy.

In the usual understanding of organ surgery, an incision is meant through which the doctor sees everything and carries out manipulations using instruments.

Laparoscopy of the gallbladder has a slightly different technology for performing the procedure. For manipulations, a special set of tools is used that avoid serious incisions.

As a rule, the procedure refers to the removal of the gallbladder, or, less commonly, the removal of stones in this organ.

The peculiarity of laparoscopy lies in the access method used for manipulation. It is carried out using a laparoscope - a special device, after which the procedure is named. The main advantage that makes this type of gall bladder surgery popular is the absence of scars after incisions in the abdominal area.

You can find descriptions of several ways to remove stones from the gallbladder. Laparoscopy is listed among them, but in reality it is performed extremely rarely, due to the characteristics of the disease itself. In practice, two situations occur:

1. In cases where there are a lot of stones and strong pathological changes have already occurred that will not allow the organ to function correctly, it is easier to remove it. Otherwise, it will constantly provoke other diseases and become inflamed.
2. If there are few stones, they are small in size, doctors suggest avoiding surgery and getting rid of the disease through medication, using litholytic therapy with drugs, for example, Ursofalk or Ursosan. Ultrasonic crushing of stones often helps, after which they pass through the intestine on their own along with the feces.

Traditional open cholecystectomy (removal of the gallbladder) is a very traumatic intervention, after which treatment requires a significant amount of time.

Fortunately, medicine does not stand still, and extensive traumatic operations have almost completely replaced minimally invasive laparoscopic interventions. The laparoscopic method allows you to recover much faster.

However, surgery is still surgery, and recovery from laparoscopy takes some time.

The operation is performed using general anesthesia. Metal conductors are used to remove connections from the organ. To do this, incisions are made in the abdomen. The intervention is carried out under the control of special devices. The stones are not crushed, but are removed whole, which eliminates the risk of damage to the walls of the gallbladder. The operation lasts about an hour. After this, the patient is admitted to the hospital for a week.

The method is not recommended for use if there are certain contraindications:

• obesity;
• the presence of large formations;
• the presence of adhesions that appeared after the intervention;
• the presence of a focus of inflammation in the organ;
• diagnosing pathologies of the cardiovascular and respiratory systems.

As for cholecystectomy, it is an operation during which the organ is removed along with the existing connections. Intervention using this method is indicated in the presence of large stones. Cholecystectomy is also prescribed to patients who often experience relapses, accompanied by severe pain, significant fever and other complications.

When the procedure is prohibited

We list the absolute contraindications to crushing stones:

• calculi are calcium in composition;
• too many inclusions: 3 or more;
• the stones are too large: their total diameter is 3 cm or more;
• blood clotting is impaired;
• there are cysts or vascular aneurysms in the path of the shock wave;
• cholecystitis;
• duodenal ulcer;
• pancreatitis;
• obstruction of the ducts;
• use of pacemakers;
• pregnancy.

Gastroenterology clinics, where they were the first to practice lithotripsy, quickly became disillusioned with this method of treatment. Expensive equipment is practically idle. And there are two main reasons for this:

1. Firstly, it turned out that after shock wave exposure, the wall of the gallbladder loses the ability to contract normally. In fact, it turns into a stone collection bag, which must be removed surgically. As practice has shown, most patients who have undergone lithotripsy sooner or later have their organ removed.
2. Secondly, evacuation of fragments in half of the cases occurs with severe colic. The high risk of its occurrence lasts 2 weeks, and at this time the patient is already at home or at work. The patient's condition in this case requires emergency medical care. If the duct is completely blocked by a large fragment, then urgent surgical intervention is required within 3 hours after the onset of colic. Otherwise, death is possible due to rupture of the gallbladder or due to painful shock.

Sharp-edged fragments injure mucous membranes along the way. These microtraumas take time to heal. Also, scratches can become a gateway to infection and provoke various inflammatory processes in the digestive tract.

Therefore, most gastroenterologists have practically abandoned such therapy, preferring to solve the problem immediately radically: by removing the gallbladder on the operating table. Thus, cholelithiasis became a surgical pathology.

Diet

If you have cholelithiasis, doctors recommend paying special attention to nutrition. A special diet for gallstones has been developed. This allows you to prevent the development of pathology and significantly improve the general condition of the patient. The following should be excluded from the diet:

• fatty meats;
• smoked meats;
• pickles;
• eggs;
• sausage;
• rich broth;
• garlic, onions and other products.

You should also give up coffee and alcoholic drinks. Instead, it is advisable to consume more cereals, fresh fruits and vegetables, fermented milk and dairy products and lean meat. Following such a diet will speed up the patient’s recovery and reduce the risk of relapse.

Cholecystectomy

A month before surgery, special preparation should be carried out. The doctor prescribes antispasmodics, drugs with antisecretory activity, diet, and polyenzymes to the patient. About three days before surgery, you need to exclude flour, vegetables, fruits, sugary drinks, dairy products, and sweets from your diet. It is forbidden to use spices and you must avoid large amounts of salt.

You will need to eat fish, lean meats and light soups. Before the operation, food should be taken no later than 19:00, and you should stop drinking water at 22:00. In the morning, you are not allowed to consume food or liquid. Before the procedure, you must undergo urine and blood tests, undergo fluorography, and a cardiogram.

Open cholecystectomy is done under general anesthesia and lasts no more than two hours. An incision is made in the middle of the abdomen or under the ribs. The gallbladder is removed and drainage is placed in the duct. This procedure is performed in rare cases, as there may be consequences.