WHAT IS THE FUNCTION OF GALL? HOW DOES THE GALL STONE HAPPEN?
The gallbladder is a pear-shaped organ located at the lower part of the liver. The gall produced by the liver flows into the duodenum through the gall ducts after meals and helps the digestion process.
The main task of gall fluid is to absorb the intestinal oils and some vitamins. Daily produced 0.5 - 1 lt. Most of the gall is stored in the gallbladder for later use. The water content of the gall in the pouch is absorbed and condensed. Due to the change in the amount of the components that form the gall and which provide its fluidity, biliary sludge and later gallstones accumulate.
WHO ARE THE GALLSTONES CONFERRED?
In some cases, the chance of stone formation in the gallbladder is high;
- Increased risk of gallstones after 40 years of age
- Genetic predisposition (30?fective)
- Female gender (especially among the blonde and light-skinned women)
- Fertility period (due to hormonal reasons) and excessive birth
- Sedentary lifestyle
- Owerweight and obesity
- Fast weight loss after obesity surgery
WHAT KINDS OF FOOD THAT THE PEOPLE WHO HAVE GALLSTONE AVOID?
Since gall secretion is stimulated by the intake of fatty foods, dietary nutrients are important.
- Heavy oily and processed meats (sausage, bologna, salami, pastrami)
- Full fat milk, full fat yoghurt and full-fat cheese
- Egg, Coffee, Nut, Pea, cracked wheat, corn
- Some sauces; such as Mayonaisse, cream
- Ice-cream, custard, puding
WHAT ARE THE SIGNS OF GALL STONE?
People with gallbladder stones usually complain of pain, indigestion, swelling, stomach rash and burning, sometimes back and shoulder pain, which begin after fatty meals (gallstone collapse). As long as there is no inflammation, these complaints usually go after 4-5 hours.
However, in cases where there is inflammation in the gallbladder (acute cholecystitis), the general condition of the patient begins to deteriorate. Add to the table weakness, chills, fever, and severe pain in the back from the right side of the abdomen. Often in this case, the emergency room will be admitted.
Sometimes there are small stones in the gallbladder and these can be poured into the channels during the contractions of the gallbladder and can cause clogging. In this case, the patient's complaints increased much more. Abdominal pain, nausea, vomiting are much more significant. In cases of inflammation spreading to the biliary tract, high fever and jaundice are added to the hospital, requiring serious hospitalization. In such cases where the liver is also affected, the so-called cholangitis is formed and can cause serious consequences if not intervened early.
HOW DOES GALL STONES DIAGNOSIS BE HELD?
Often, the patient's complaints lead us to the gallstones. Ultrasound and some blood tests performed after a fasting period of at least 6 hours are useful for understanding the stone in the gallbladder and its effects.
However, in some cases the imaging method called MRCP is used to evaluate the condition of the liver and gall ducts. In this way, the liver, biliary tract, gallbladder, pancreas and pancreas channel are displayed.
WHAT ARE THE TREATMENTS OF GALL STONES?
Generally, when the gallstones are diagnosed, the patient has complaints. For long-standing bloating, indigestion, stomach pain and nausea, most patients have received gastric ulcer or gastritis treatment. For this reason, surgery is recommended for people with symptomatic symptoms. Surgical planning should be done as soon as possible due to the possibility of being cast into the gall ducts, especially those with very small stones called millimeters.
In diabetic patients, a purulent inflammation may progress rapidly and surgery is recommended when gallstones are detected.
We have two options in cases of cholecystitis accompanied by inflammation of the gallbladder :
- In the first option, the patient is operated immediately within 24-48 hours. In this way, the gallbladder, which is the source of the inflammation, is eliminated and the inflammation is prevented from progressing into the gale ducts and other intraabdominal areas. The most important disadvantage of this method is that sometimes there is adherence due to inflammation and there is not enough vision for laparoscopic (closed) surgery and it is the risk of return to open surgery.
- The other option is that the patient is admitted to the hospital with serum and antibiotic treatment, restriction of the diet and follow-up until the general condition is recovered. The planned operation time after the patient's recovery is 4 weeks later. The disadvantage of this option is the possibility that the patient may have a re-attack within the expected 4-week period.
ERCP (Endoscopic Retrograde cholangiopancreaticography) is the procedure to be performed if there are stones in the gale ducts without inflammation. It is the endoscopic way to clear the stones from the gale duct through the mouth of the duodenum through the mouth. The patient can perform gall bladder surgery after cleaning the gale duct interior with this method.
HOW IS THE GALLBLADDER OPERATION?
It is removed with stones in the gallbladder. In the absence of the pouch, the body's gale needs are met by the liver.
The operation is performed by laparoscopic method (closed) through four holes in the abdomen. The duration is approximately 45 - 60 minutes. The length of hospital stay after surgery is one day.
The most feared complication of surgery is the possibility of returning to open surgery. Although this condition is very rare, it is mostly seen in patients who have a large number of painful attacks and inflammation. Due to the recurrent adhesions after each attack, the possibility of injury to other abdominal organs and the fact that the laparoscopic vision is troublesome are reasons for open surgery.
In open surgery, the wound site is larger, the duration of surgery, the length of hospital stay and the postoperative recovery period are longer.