DR KUMAR treats and operates on patients with gallbladder on a daily basis. And LAPAROSCOPIC GALLBLADDER SURGERY is his favorite surgery. Making him truly a GALLBLADDER SPECIALIST.
SURGEON DR KUMAR
BEST GALLBLADDER STONE TREATMENT IN CHENNAI,INDIA | DR KUMAR GALLBLADDER SPECIALIST
Gallbladder stones commonly called as Gallstones are been increasingly seen in the General Population.The classical description of Gallstones being common in Fat, Forty, Fertile, Female no longer applies.It is increasingly seen in all ages,even in small Children,men and Female and more incidence during and after Pregnancy.
If you are Diagnosed with or suspect you have Gallstones and looking for the Best Gallbladder Stone ( Gallstone) Treatment in Chennai ,India then Dr Kumar at Billroth Hospital is the Top Choice .Dr Kumar at Billroth Hospital is the most trusted Doctor for Gallbladder Stones Treatment in Chennai ,Tamilnadu. He has 29+ years experience in Treatment of Gallbladder stones and Gallbladder Surgery and has successfully performed 5000+ Gallbladder Surgeries including Complex and Complicated Gallbladder Surgeries- Most of them by Laparoscopy. Dr Kumar has 29+ years of experience and an expert in the Laparoscopic Cholecystectomy- the Gold Standard Treatment for Gallstones– and Robotic Cholecystectomy.
WHAT ARE GALLBLADDER STONES?
Gallbladder stones are Hardened pebble like deposits of Digestive Fluid(Bile) that form in the Gallbladder.They are mostly composed of Bile pigments (Bilirubin) and Cholesterol.They may vary in size from small sand grain size to a big lemon size stones.Some people may have a Single large stone and Some have multiple small stones.
TREATMENT FOR GALLBLADDER STONES
DR KUMAR of Billroth Hospitals has 29+ years of experience in Treatment of Gallbladder stones and Highly Skilled in Complicated and Complex Gallbladder stone Surgery.
OBSERVATION
Many times small,asymptomatic stones can be watched and Just observed.
MEDICAL TREATMENT
Sometimes small,single asymptomatic stones may respond to Medical treatment with Ursodeoxycholic Acid medicine ,the assurance of Dissolution and the duration the Medicine to be continue remain uncertain.
LAPAROSCOPIC CHOLECYSTECTOMY
The Gold Standard of Treatment for Symptomatic Gallstones remain LAPAROSCOPIC CHOLECYSTECTOMY and DR KUMAR with 29+ years of experience , and 5,000 Gallbladder Surgeries,is a Master of Laparoscopic Cholecystectomy. Even for very Severely Infected, perforated, gangrenous and Complicated and Complex Gallbladder ,he has successfully performed Laparoscopic Cholecystectomy.He was also one of the First Surgeon in Chennai to start performing LAPAROSCOPIC CHOLECYSTECTOMY making him the Top Choice for Gallbladder Stone Surgery
ROBOTIC CHOLECYSTECTOMY
With technological Advancement Gallbladder Surgery is carried out using ROBOTIC approach and DR KUMAR at Billroth is highly skilled in ROBOTIC CHOLECYSTECTOMY .Mostly for Complex Gallbladder Surgeries ,Robotic Surgery offers better Precision, Magnifications and lesser Pain compared to Laparoscopic Surgery giving Faster Recovery.
OPEN SURGERY
DR KUMAR very rarely performs Open Surgery and is Preformed in Complicated situation like Cholecysto Duodenal Fistula which requires Duodenal Repair
ERCP- Endoscopic Retrograde Cholangiopancreatography
ERCP is most commonly performed for treatment for Bile Duct Stones, avoiding the need for open surgery.
ERCP is an advanced, minimally invasive procedure used to treat Bile Duct Stones- Gallbladder stones that have migrated into the common bile duct -Choledocholithiasis. It is especially helpful in patients with jaundice, cholangitis, or Pancreatitis caused by bile duct obstruction.
WHAT DOES THE GALLBLADDER DO
The Gallbladder is a small pear shaped organ situated just beneath the Liver on the Right side upper part of the Abdomen. The capacity is the Gallbladder ranges from 50 to 100 ml.In pathological Conditions the Gallbladder may expand to 200 to 300ml volume also. The Gallbladder is a Temporary storage organ for Bile.We have to understand that more than one liter of Bile is formed from the Liver everyday and only a small amount is stored in the Gallbladder. Whenever we eat extra Fatty food, an enzyme called Cholecystokinin is secreted from the Small Intestine which causes the Gallbladder to Contract and release the stored Bile into the Intestine via the Common Bile Duct and this extra Bile Aid in Fat digestion.
The Important point to notes is,
- Digestion occurs in the Stomach and the Intestine and not in the Gallbladder, as falsely believed by many people
- Only a part of Bile is stored in the Gallbladder.All the Bile formed is not Stored in the Gallbladder.
- Gallbladder plays a minimal role in digestion and the Whole digestive system is not dependent on Gallbladder as believed Paradoxically by many people.
WHAT IS BILE
The Bile is a Digestive Juice formed in the Liver and secreted by the Liver cells.The Hepatocytes into the Biliary ductules,which unite to form the Bigger Biliary Duct.
The Bile is composed of;
- Water
- Bile Salts- Ursodeoxycholic acid and Chenodeoxycholic Acid which helps in breaking down fat to fatty acids which are absorbable.
- Bile pigments which are breakdown substances of old Blood Cells-RBS,which form a Substance called Heme and these are excreted in the Bile.The Bilirubin pigment is the reason the stools are yellow in colour.
- Cholesterol - the bad Cholesterol in the Blood is excreted through the Bile and Hence while taking Cholesterol lowering agent there is increased Cholesterol in Bile.
FUNCTIONS OF BILE
- Helps in Digestion of Fat
- Helps in Excretion of Breakdown products of Blood Cells- Heme
- Helps in excretion of Cholesterol
PATHWAY OF BILE
- Bile is secreted by the Hepatocyte into the Biliary ductules
- These ducts combines to form the Major ducts- The Right Hepatic duct and Left Hepatic Duct which exits from the Left Lobe and Right Lobe of Liver; these two ducts combine to form the Common Hepatic Duct.The Gallbladder join the Common Hepatic Duct through the Cystic duct to form the Common Bile Duct -CBD, which then transverse through the head of the Pancreas and Open into the second part of the Proximal Small Intestine called the Duodenum .Before opening into the Small Intestine, it is joined by the Pancreatic Duct carrying the Pancreatic Juice. The opening of the Common Bile Duct into the Intestine is Prominent and called the Ampulla of Vater..This is the pathway of Flow of Bile.
- These ductules form the segmental and sectoral ducts
HOW DO GALLBLADDER STONES FORM | CAUSES
When the Bile contains too much Cholesterol
Normally the Bile Contains Bile salts which help in dissolving the Cholesterol excreted by the Liver.However when the Liver secretes more Cholesterol ,than the Bile may not be able to dissolve the Cholesterol and the excess Cholesterol many forms into Stones.
When Bile contains too much Bilirubin
When there is excess of red Blood cells breakdown,more Heme and More Bilirubin is formed, which leads to stone formation.This occurs in conditions like Liver Cirrhosis.biliary Tract Infection and certain Blood disorders. The excess Bilirubin leads to Gallstone formation.
When there is Improper / delayed emptying of Gallbladder
In the Gallbladder does not empty completely or often the Bile becomes very concentrated leading to Gallstone Formation.This occurs when taking oral Contraceptives pills and other hormonal medications.
TYPES OF GALLBLADDER STONES
CHOLESTEROL STONES
The most common type of Gallstones,often yellow in colour and contains undissolved Cholesterol
PIGMENT STONES
Are dark in colour and Brown or Black stones when the Bile Contains too much Bilirubin
RISK FACTORS FOR GALLBLADDER STONES
The factors which increases the risk of Gallstones includes
Female
40 years and older
Obesity/ Overweight
Sedentary
Pregnancy
High Fat Diet
High Cholesterol diet
North east part of India
Low Fiber Diet
Family history of Gallstones
Diabetics
Blood disorders like Cell anemia/ Leukemia
Loosing weight very quickly
Medications containing estrogen such as oral Contraceptives or Hormonal therapy
Liver diseases
PREVENTION OF GALLSTONES
We can reduce the risk of Gallbladder stone Formation if you follow these points.
Don’t skip meals- Stick to the Usual meal time each day.skiping meals or fasting can increase the risk of Gallstones
Lose Weight slowly – Rapid weight loss leads to Gallstone formation
Aim to lose 0.5 to 1 kg per week
High Fiber Food- Include more Fiber food in the Diet such as fruits,vegetables and Whole grains
Healthy Weight – Obesity and more weight increase the risk of Gallstones.Try to achieve and maintain a healthy weight and regular physical activity is necessary
Healthy diet and regular physical exercise is necessary .
COMPLICATIONS OF GALLBLADDER STONES
Dr KUMAR at Billroth Hospitals has huge experience of 29 + years in the Treatment of Complicated and Complex Gallbladder stones.He has huge expertise in the Treatment of Gallbladder Stone Complications and has performed 5,000+ successful Gallbladder Surgeries
Infection and Inflammation of the Gallbladder
The Gallstone can become lodged in the neck of the Gallbladder and can cause Inflammation of the Gallbladder (Cholecystitis) .The Gallbladder wall becomes thickened and Patient develop pain and Fever.
Mucocele of the Gallbladder
The Stone may get impacted in the neck causing progressive and Huge enlargement of the Gallbladder filled with Mucous.
Empyema of the Gallbladder
The Gallbladder becomes filled with pus leading to sepsis
Perforation and Gangrenous Cholecystitis
Sometimes the Infection in the Gallbladder came become severe to cause Perforation and Gangrene of the Gallbladder leading to Peritonitis
Jaundice
The Gallstone can migrate to the Bile Duct leading to obstruction to Bile Flow leading to Jaundice patient presents with Yellowish urine, Raised Liver Function Test and Abdomen Pain.
Pancreatitis
The migrated Gallbladder stone can cause blockage of the Pancreatic Duct leading to Inflammation of the Pancreas and Pancreatitis. The Inflammation can vary from mild to severe Pancreatitis which can become Life Threatening.
Cholecystoduodenal Fistula, Gallstone Ileus
The Gallbladder can erode into the Duodenum causing a Fistula between the Gallbladder and Duodenum, Gallbladder Ileus .When the Gallstones may cause Obstruction in the Small Intestine.
Mirizzi’s Syndrome
There is a Communication between the Gallbladder neck and the adjacent Bile Duct leading to Cholecysto Choledochal Fistula
HOW TO DIAGNOSE GALLBLADDER STONES
- Ultrasound : The Best modality and Investigation to diagnose Gallbladder Stone is an Ultrasound of the Abdomen.It is Better to do the Ultrasound in empty stomach which leads to better visualization of the Stones.
- CT Scan with Contrast of the Upper Abdomen when we are suspecting complications of the Gallbladder Stone and Perforation/ Gangrene and to rule out Associated Pancreatitis.A word of Caution. 20% of Gallbladder stones ae Radiolucent and maynot be picked up by CT scan.
MRI Upper Abdomen with MRCP: This is necessary whenever we are suspection a stone in the Bile Duct and to rule out complicated Gallbladder Stone.Infection and Associated Pancreatitis MRCP is particular indicated in patients with Gallstones and Raised Liver Function Test.
Biochemical Test are usually done to rule out Jaundice Liver Function Test and CBC to rule out Infection ,serum Amylase and Lipase usually done to rule out Pancreatitis.
SYMPTOMS OF GALLSTONES
If you experiencing pain/discomfort in your right upper Abdomen especially after fatty food,you maybe having Gallstones.
Sometimes you may experience fullness and Bloating after Fatty food, this may indicate Gallstones.If you suffering from the Symptoms,its better to Consult a Specialist in Gallbladder like Dr Kumar of Billroth Hospitals,who will be able to diagnose and treat your Symptoms properly.The Common Symptoms of Gallstones are
Asymptomatic or Silent
Most of the time the Gallstones are asymptomatic and Diagnosed with Routine Scan.
Dyspepsia
Maybe fullness and Bloating of the Abdomen after fatty meals and also some pain in the Right Upper Abdomen
Biliary Colic
Sometimes patients may have recurrent right upper abdominal pain radiating to back-Biliary Colic.
Jaundice
When a stone Migrates to the Bile duct it leads to Jaundice,patient may have yellowish discoloration of eyes and Yellowish urine
Nausea / Vomiting
Whenever there is infection in the Gallbladder there maybe Associate nausea /vomiting
Severe Pain
Right upper Abdomen is the Indication of Cholecystitis
Severe Pain upper Centre
Abdomen with Abdomen Distention Usually a indication for Pancreatitis
WHEN TO SEE A DOCTOR
Make an Appointment with a Gallbladder stone specialist like DR KUMAR ,if you have any of these Symptoms,
Right Upper Abdomen discomfort associated with Bloating especially after fatty meals
Severe Right Upper Abdomen / Centre Abdomen pain which may indicate Infection in the Pancreas
Jaundice- When you notice yellowish colour of the eyes and urine which may be secondary to Bile Duct stones
Jaundice- When you notice yellowish colour of the eyes and urine which may be secondary to Bile Duct stones
DAYCARE LAPAROSCOPIC CHOLECYSTECTOMY
With Increasing the cost of Surgery and Hospital stay,Gallbladder Stone Surgery is being increasing performed as Daycare Surgery to reduce the duration and cost of Hospital stay.
Daycare Gallbladder Surgery involves the same day discharge after Gallbladder Surgery.Patients come to the Hospital in the morning,Surgery is done and the patient sent home in the evening . This procedure is most commonly performed using Laparoscopic or Robotic Cholecystectomy.
WHO IS SUITABLE FOR DAY CARE SURGERY
Medically stable patients
Well-controlled medical conditions
No evidence of bile duct stones
Adequate home support after discharge
Living within reachable distance of the hospital
BENEFITS OF DAY-CARE
SURGERY
Same-day discharge
Minimal pain and small incisions
Faster recovery
Lower risk of hospital-acquired infections
Early return to normal activities
FREQUENTLY ASKED QUESTIONS
1) How long is the recovery after Gallbladder Surgery?
Most Patients return to normal activity within 5-7 days
2) Can Gallstones come back after Surgery?
No, After surgery Gallstones cannot recur.
3) What happens if Gallstones are not Treated?
Untreated Gallstones can cause complications like Severe abdominal pain, Infection.Jaundice,Pancreatits Early Treatment prevents serious complications
4) Can I live normally without a Gallbladder?
Yes, The Liver continues to produce Bile and People live a completely normal life after Gallbladder removal
5) Are there dietary restrictions after Gallbladder removal?
Initially a light low fat diet is advised.Most patients can gradually return to a normal balanced diet within a few weeks.