Ouch!
I Think My Gall Bladder Hurts!
Jody C. DiGiacomo, M.D., FACS
Department of Surgery
CentraState Medical Center
What Is The Gall Bladder?
A Bag Shaped Organ
Under the Liver That
Holds, Concentrates and Stores
Bile
Biliary System
Bile is Made by the Liver
Flows Into Small Channels
Converge Into Large Ducts
Stored in Gall Bladder
Moves Into Intestine When Needed
What Is Bile?
Dark Green and Bitter Tasting
Functions:
Aid Digestion of Fats
Help Neutralize Stomach Acid
Excretion of Complex Wastes
Composition:
85% Water
10% Bile Salts
3% Pigments
1% Inorganic Salts & Cholesterol
What Are Gall Stones?
Result of An Imbalance Between the
Components of Bile
Age
Ethnicity
Diet
Medical Conditions
What Is Biliary Colic?
Right Upper Quadrant Pain
Epigastric Pain
May Be Severe
Nausea, Vomiting
Lasts > 1 Hour and < 24 Hours
Anatomy
Anatomy
Anatomy
Symptomatic Cholelithiasis
67% of Patients With Gall Stones
Remain Asymptomatic
70% Will Have Recurrent Episodes
6-8% Will Need Surgery Each Year
Diagnosis
History and Clinical Exam
Abdominal X-Rays
Ultrasound
CT Scan
HIDA Scan
Treatment Options
Cholecystectomy
The Surgical Removal of the Gall Bladder
Stone Removal Does Not Cure Condition
Laparoscopic Cholecystectomy
Under General Anesthesia
Tubes Placed Thru the Abdominal Wall
The Abdomen Is Filled With Air
Long Instruments Are Used To
Remove the Gall Bladder From the Liver
Removed From The Abdomen
Via the Umbilicus
Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy
If The Gall Bladder
Can Not Be Safely Removed Laparoscopically,
The Abdomen Must Be Opened
In The Traditional Manner
Open Cholecystectomy
Open Cholecystectomy
Open Cholecystectomy
Open Cholecystectomy
Laparoscopic Vs Open
Less Post Operative Pain
Faster Recovery
Faster Return to Life
Less Pain Medications
Biliary Pain After Surgery
Abdominal Pain
and Other Symptoms
May Persist or Recur
In up to 20%
Diet After Surgery
No Specific Restrictions
Individualized Intolerences
Gall Stones
A Common Finding In Many
Symptomatic in Few
Surgery Warranted for Symptoms
Laparoscopic Cholecystectomy
Few Contra-Indications
Same Day Surgery or Overnight
General Anesthesia
1-2% Require Conversion To Open