• Gallstones removal from gallbladder cavity. Surgery process.
• Gallstones removal from gallbladder bile duct. Surgery process.
• Gallbladder preserving surgery indications.
• Gallbladder preserving surgery contraindications

 

To consider the possibility of surgery - email your ultrasound to nogallstones@gmail.com

 

Surgery to remove gallstones from the gallbladder without removing the gallbladder. Removal of gallstones.

Removal of gallstones with preservation of the gallbladder. The operation process.

With the help of high–tech devices – a choledochofiberoscope, a solid choledochoscope, a laparoscope and other equipment, an incision of 1.5 - 2cm is made in the area of the lower costal arch to enter the abdominal cavity. Then, using a 5 mm mini laparoscope, the general position of the abdominal organs, as well as the position of the gallbladder, its size, the absence of tissue adhesions and abnormal neoplasms are studied.

The operation to remove gallstones from the gallbladder without removing the gallbladder is performed under general anesthesia.
The operation is performed through small incisions, which are performed in most cases in the following places:

lower costal arch (1.5-2 cm)
umbilical opening (0.5 cm)
During the operation, high-tech equipment is used - a choledochoscope, a choledochofibroscope, hard and soft endoscopes, etc. The combined use of hard and soft endoscopes gives the clearest picture of the condition of the mucous membrane, the number of stones, their size and localization.

Through an opening on the costal arch, a mini-laparoscope is inserted into the abdominal cavity, which allows you to study the position of the organs of the gastrointestinal tract, the condition of the gallbladder - its size, the presence of pathological neoplasms.

After that, an incision is made at the base of the gallbladder, through which a flexible tube is inserted, secured with a pouch seam.

The choledoscope is inserted into the gallbladder cavity through a tube without injuring the surrounding tissues. This design ensures complete tightness and prevents the leakage of bile into the abdominal cavity and irritation of the peritoneum.

With the help of endoscopic capture, the extraction of bile concretions is carried out. Stones located in the bile ducts and large stones are pre-crushed by pneumatic lithotripsy.

After the removal of all concretions, the gallbladder cavity is re-examined, the choledoscope is removed. The incision at the bottom of the gallbladder is sewn up using absorbable threads.

Medical glue allows you to close the incisions in the area of the right hypochondrium and the umbilical opening. Such a seam provides a reliable bond and a good cosmetic effect, leaving only a thin strip in its place.

The stones extracted from the gallbladder are sent to the laboratory for examination to determine their chemical composition.

8 hours after the operation, the patient can get up and walk independently.

Discharge from the hospital usually occurs 4-5 days after surgery.

 

Surgery to remove stones from the bile duct. The operation process.

When stones are found in the bile duct according to ultrasound results, their immediate removal is recommended.

What is the danger of such a situation and why it is impossible to postpone surgical treatment?

In most cases, stones clog the duct, which is the cause of the development of cholecystitis.

A unique minimally invasive endoscopic surgery to remove stones from the bile duct, developed by Professor Qiao Tie, is performed as follows:

A guide cap is put on the front end of the endoscope.

By circling and pressing, the endoscope is inserted into the bile duct to accurately diagnose the presence of stones and their location.

It is worth noting that in the process of research and development of the operation, the professor identified several main ways to extract concretions using different equipment:

If the stones in the bile duct are relatively small in size, and at least a little mobile, and if there is a space between the stones and the wall of the gallbladder, then they can be removed using a basket, which first captures the stone, and then removed from the bile duct.
If the stones are not solid, and they can be crushed and extracted, then special forceps are used in this case.
There are cases when the stones are immobile in the bile duct, i.e. they have grown to the wall of the duct. To extract such stones, the method of pneumatic lithotripsy is used-crushing stones directly in the duct. Then, using a basket or forceps, the stone particles are extracted.

A sign of a successful operation is that after removing the stones, the bile begins to flow freely out of the duct.

It is possible to arrive for minimally invasive endoscopic surgery to remove stones from the bile duct after obtaining a preliminary admission.

Send an ultrasound of the gallbladder by e-mail: nogallstones@gmail.com and find out if you can perform this operation.

 

Indications to surgery:

• a single stone with an echo of more than 4 mm or multiple stones of any size in the gallbladder cavity;
• a single polyp in the gallbladder larger than 5 mm.;
• multiple polyps in the gallbladder of any size ;
• one or many stones in the bile duct, sand in the bile duct;
• stones attached to the walls of the gallbladder or embedded in the walls;
• putty-like thick bile with sand in the cavity or bile duct.
• putty-like stagnant bile with sand

Contraindications to surgery:

• operations on the abdominal cavity, heart (all cases are considered individually);
• inflammation of the gallbladder (in the absence of pain, a slight thickening of the wall at the bottom of the gallbladder is not a contraindication);
• diabetes mellitus (discussed);
• coronary heart disease;
• tuberculosis;
• cirrhosis of the liver;
• choledocholithiasis - the presence of stones in the common bile duct requires the preliminary conduct of another operation;
• the size of the gallbladder is less than normal;
• BMI (body mass index) more than 29 (individually);
• gallbladder atrophy;
• intrahepatic gallbladder;
• Mirizzi syndrome;
• pyelonephritis (confirmation of diagnosis is required);
• acute pancreatitis;
• inability to undergo surgery for general health reasons;
• suspected malignant tumors in the abdominal cavity;
• age less than 6 years old;

Age over 60 is NOT a contraindication.

The presence of a mesh on the umbilical opening, an umbilical hernia or a lot of adhesions in the abdominal cavity are not a contraindication. In this case, the operation is performed through 1 incision on the right hypochondrium.

The body of each person is individual, and in some cases exceptions are possible

It is possible to arrive for minimally invasive endoscopic surgery to remove stones from the bile duct after obtaining a preliminary admission.

Send gallbladder or abdomen Ultrasound or MRI or CT to e-mail: nogallstones@gmail.com and find out if you can undergo the gallbladder preserving surgery.