Do you need a gallbladder to live: Gallbladder removal – NHS
Gallbladder removal – NHS
Gallbladder removal surgery, also known as a cholecystectomy, is a very common procedure.
The gallbladder is a small, pouch-like organ in the upper right part of your tummy.
It stores bile, a fluid produced by the liver that helps break down fatty foods.
You don’t need a gallbladder, so surgery to take it out is often recommended if you develop any problems with it.
Why does my gallbladder need to be removed?
Surgery to remove the gallbladder is usually carried out if you have painful gallstones.
These are small stones that can form in the gallbladder as a result of an imbalance in the substances that make up bile.
Gallstones often cause no symptoms and you may not realise you have them, but occasionally they can block the flow of bile and irritate the gallbladder (acute cholecystitis) or pancreas (acute pancreatitis).
This can cause symptoms such as:
- sudden and intense tummy pain
- feeling and being sick
- yellowing of the skin and the whites of the eyes (jaundice)
Very occasionally it may be possible to take tablets to dissolve gallstones, but surgery to remove the gallbladder is the most effective treatment in the vast majority of cases.
What happens during gallbladder removal surgery
There are 2 main ways of removing a gallbladder:
- laparoscopic (keyhole) cholecystectomy – several small cuts (incisions) are made in your tummy (abdomen) and fine surgical instruments are used to access and remove your gallbladder
- open cholecystectomy – a single larger incision is made in your tummy to access and remove your gallbladder
Keyhole surgery is used most often because you can leave hospital sooner, recover faster and are left with smaller scars than with an open procedure.
Both techniques are performed under general anaesthetic, which means you’ll be asleep during the operation and won’t feel any pain while it’s carried out.
Find out more about how gallbladder removal surgery is performed
Recovering from gallbladder removal surgery
It doesn’t usually take long to recover from keyhole surgery to remove your gallbladder.
Most people can leave hospital the same day or the next morning.
You’ll probably be able to return to most of your normal activities within 2 weeks.
It takes longer to recover from open surgery. You may need to stay in hospital for 3 to 5 days and it could be 6 to 8 weeks before you’re feeling back to normal.
Find out more about recovering from gallbladder removal surgery
Living without a gallbladder
You can lead a perfectly normal life without a gallbladder.
Your liver will still make enough bile to digest your food, but instead of being stored in the gallbladder, it drips continuously into your digestive system.
You may have been advised to eat a special diet before surgery, but this doesn’t need to be continued afterwards.
Instead, you should aim to have a generally healthy, balanced diet.
Some people experience problems such as bloating or diarrhoea after surgery, although this usually improves within a few weeks.
If you notice certain foods or drinks trigger these symptoms, you may wish to avoid them in the future.
Find out more about diet after gallbladder surgery
Risks of gallbladder removal surgery
Gallbladder removal surgery is considered to be a safe procedure, but, like any type of surgery, there’s a risk of complications.
Possible complications include:
- wound infection
- bile leaking into the tummy
- damage to one of the openings (ducts) carrying bile out of the liver
- blood clots
Speak to your surgeon about the benefits and risks of surgery before your operation.
Find out more about the complications of gallbladder removal surgery
Page last reviewed: 03 December 2018
Next review due: 03 December 2021
Living Without a Gallbladder | Digestion After Gallbladder Removal
The gallbladder is a small, pear-shaped organ that stores and releases bile, a fat-digesting juice made in the liver. Gallbladder removal—cholecystectomy—is one of the most common surgeries in the United States. It’s a treatment for painful obstruction caused by gallstones and other gallbladder problems.
The gallbladder is not a critical organ—you can live without it. But, it can take time for your body to adjust to its absence. Right after surgery, high-fat foods can cause stomach discomfort and diarrhea. Many people who have their gallbladder removed are able to get relief from these symptoms by changing their diet or taking medicine. Here’s what you need to know about living without a gallbladder.
Digestion After Gallbladder Removal
The gallbladder aids digestion by storing and concentrating bile. Normally, bile flows from the liver into the gallbladder for storage. When you eat a meal, the gallbladder normally releases a pool of bile into the small intestine to begin digesting fat. But this job is not critical for digestion or good health.
Without the gallbladder, the liver still produces the bile necessary to digest fat in food. But instead of entering the intestine all at once with a meal, the bile continuously drains from the liver into the intestine. This means it may be harder and take longer for your body to digest fat.
Many people don’t notice changes to their digestion or other effects of gallbladder removal. Others experience bloating and diarrhea after eating fatty foods. For some people, symptoms last only a few weeks. Other people have chronic problems—including diarrhea—after gallbladder removal. Your doctor will probably recommend a special diet after gallbladder removal while your body adjusts. If diet and lifestyle measures don’t offer adequate relief, medicines may help.
Many people worry that they won’t be able to eat normally after gallbladder removal. Generally, you can eat what you like—it just may take a few days for your appetite to return. If you find you’re having symptoms after your appetite returns, there are things you can try to help your digestion. Try making the following changes to your diet:
- Eat a low-fat diet. Avoid fried foods, junk foods, whole-milk dairy products, and fatty meats.
- Eat small, frequent meals instead of a few, large ones.
- Limit butter, oil and sweets.
- Avoid rich, creamy soups, sauces and gravies.
- Avoid spicy foods.
- Add fiber to your diet. Cereals, whole-grain breads, nuts, beans, vegetables, and fruit add bulk to your stool. These foods can worsen gas, so add them to your diet gradually.
Problems with digestion after gallbladder removal are usually temporary. If your digestive problems persist, talk with your doctor. Together, you can work out a treatment strategy that meets your needs.
5 Signs That You Might Need Gallbladder Surgery
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Unless you’ve felt the stabbing pain of gallstones, most likely you’ve never given your gallbladder a second thought. But this small organ can trigger big problems. Learn the signs and symptoms of gallbladder trouble, and when it’s time to seek a surgeon’s advice.
What Is the Gallbladder And What Does It Do?
The gallbladder is a small, pouchlike organ in the upper right part of your abdomen (belly). The gallbladder collects and stores bile, a fluid produced by the liver that helps break down fatty foods.
Why Does Your Gallbladder Need To Be Removed?
You may need gallbladder surgery if you have pain or other symptoms caused by gallstones — small stones that can form in the gallbladder. They can block the flow of bile and irritate the gallbladder. Common symptoms of gallbladder problems include:
- Indigestion, with bloating, heartburn, and gas
- Sharp pain in your belly
- Nausea and vomiting
- Yellowing of the skin and the whites of the eyes (jaundice)
The good news? You don’t need a gallbladder to live, so if it’s causing severe problems, your doctor will likely recommend surgery to remove it.
You may need gallbladder surgery if you have pain or other symptoms caused by gallstones.
How Is the Gallbladder Removed?
There are two ways of removing the gallbladder. Both are performed under general anesthesia, which means you’ll be asleep and pain-free during the operation. Talk with your health care provider about which one is right for you:
- Laparoscopic (keyhole) cholecystectomy (gallbladder removal): This is the most common way to remove the gallbladder.
- The surgeon makes several small incisions, or cuts, in your abdomen. She then inserts a laparoscope — a thin, lighted tube that lets her see inside your belly — through one of the cuts.
- Other medical instruments, including a tiny camera, are inserted through the other cuts. Gas is pumped into your belly to expand the space, so your surgeon has more room to see and work.
- The gallbladder is removed using the laparoscope and other instruments. The surgeon closes the incisions with small stiches, staples, surgical tape, or glue. These will disappear as you heal, so your doctor won’t have to remove them later. With this method, you can leave the hospital sooner and recover faster.
- Open cholecystectomy: In some cases, laparoscopic gallbladder removal may not be possible. Reasons include severe gallbladder problems or scar tissue in the abdomen from earlier surgery. With open surgery, your surgeon will make a single, larger incision in your belly to access and remove your gallbladder. She will then close the incision with stitches and cover it with a dressing.
Sometimes a laparoscopic procedure turns into an open one during the operation if your surgeon can’t see your gallbladder clearly or remove it safely. If you’re scheduled for a laparoscopy, talk with your doctor ahead of time about the risk of it becoming an open procedure.
What Are the Risks of Gallbladder Removal?
Gallbladder removal surgery is considered a standard, safe procedure. Complications of laparoscopic surgery are rare. But, like any type of surgery, there’s a risk of complications, which can include:
- Infection in the surgery area
- Blood clots
- Bile leakage
- Heart problems
- Hernias (when a small amount of your gut, or intestine, or other tissue bulges through the muscles that cover it)
Ask your doctor about the benefits and risks of surgery before your operation.
How Long Does It Take To Recover From Gallbladder Surgery?
Your recovery time will depend on which procedure you had.
- Laparoscopic: Most people can leave the hospital on the same day or the day after the operation. If you leave that day, have someone stay with you for at least 24 hours as you may still be feeling the effects of the anesthesia. You’ll likely be able to return to your normal activities in about two weeks.
- Open: Usually you’ll have to stay in the hospital for three to five days afterwards. Recovery takes about six to eight weeks.
It’s easy to get the care you need.
See a Premier Physician Network provider near you.
Sources: National Health Service; Society of American Gastrointestinal and Endoscopic Surgery; Medline Plus
Life after Gallbladder Removal | Everyday Health
However, when you remove the gallbladder, you remove the reservoir, Brugge says. So, even though you will have the same amount of bile in your body, you will not have as much bile in your intestine after your gallbladder is gone.
“The bile is constantly being delivered into your intestine instead of being stored,” Brugge explains. In theory, this means that you will not digest food as well.
“But most animal species in the world don’t have gallbladders,” Brugge says. And your gallbladder is an organ you can live without.
Digestion Changes After Gallbladder Removal
In the first few weeks after your surgery, your doctor probably will recommend that you eat a mostly low-fat diet while your body adjusts to living without a gallbladder. After that, “ninety percent of people go back to eating the way they did before,” says Brugge.
Brugge says that digestive symptoms are relatively uncommon after gallbladder removal. But some people will notice a change in their digestion.
“The most common thing is people have more frequent bowel movements,” Brugge says.
Laura Consolo of Melrose, Mass., had her gallbladder removed 12 years ago and has experienced some digestive changes.
“I probably noticed the change about two months after the surgery,” says Consolo, now in her early forties. “If I ate a lot of fatty foods, I would have a really bad stomachache and need to run to the bathroom,” she continues. “It was pretty much a constant thing for a while.”
Managing Digestive Problems After Gallbladder Removal
Brugge notes that gallbladder removal-related digestive symptoms usually go away over time, but that some people need to take medications or make lifestyle changes to help manage their symptoms. “There are medications [people can] take that will bind the bile,” says Brugge.
Some of the lifestyle changes that can help ease digestive symptoms when you’re living without a gallbladder are:
- Adopt a low-fat diet
- Avoid eating fatty foods, such as fried foods
- Eat small, frequent meals
- Avoid eating a very large dinner after fasting all day
Consolo says that she took medications to manage her symptoms, but eventually wanted to wean herself off these drugs. She is now able to manage her symptoms with a high-fiber, low-fat diet.
Can I Live Without My Gallbladder?: Johnny L. Serrano, D.O., F.A.C.O.S: Board Certified General Surgeon
Every organ in your body has its own unique function and purpose, but not all of them are vital to your continued health or survival. In fact, plenty of people lose non-vital organs to disease or injury without suffering ill health consequences.
You can live without one of your lungs or one of your kidneys; you can also live without your reproductive organs. There are also no disadvantages to losing your appendix, and if you lose your spleen, your liver takes over to fulfill its role in immune system function.
You can live also without your gallbladder — and that’s exactly what you may be advised to do if you develop obstructive and inflammatory gallstones that cause severe pain or discomfort.
As a board-certified general surgeon who specializes in minimally invasive gallbladder removal (cholecystectomy), Johnny L. Serrano, DO, FACOS, can help you understand the ins and outs of gallbladder removal, including what you can expect after the procedure.
Your gallbladder is a hollow, pear-shaped organ nestled beneath your liver. Its only job is to store and concentrate bile, an important digestive fluid from the liver that breaks down dietary fats and helps remove toxins and waste products from your body.
Your liver and your gallbladder are part of the same, interconnected system, but they couldn’t be more different: your liver is one of the largest, most complex, and most vital organs in your body, while your gallbladder is one of the smallest, simplest, and least critical.
That’s good news if you happen to develop gallstones, or hard, pebble-like pieces of bilirubin or cholesterol that can obstruct the flow of bile from your gallbladder to your small intestine.
Gallstones affect up to 15% of adults in the United States, or some 25 million men and women. About one in four people with gallstones experience symptoms that require prompt treatment, usually in the form of gallbladder removal surgery.
Gallstones that block your biliary tract can give rise to an acute gallbladder attack that causes severe abdominal pain; they can also increase your risk of developing serious complications including gallbladder inflammation, gallstone pancreatitis, liver damage, and even sepsis.
Gallbladder surgery is the only treatment for problematic gallstones that puts an immediate end to excruciating gallbladder attacks and effectively removes the potentially life-threatening health complications they can trigger.
Surgical removal options
Advances in minimally invasive surgical techniques have made it possible to perform most cholecystectomies laparoscopically, rather than with a conventional open approach.
Unlike an open cholecystectomy, which accesses your gallbladder through one large incision, laparoscopic gallbladder surgery uses four tiny incisions, specialized tools, and a high-definition camera to access the area with minimal tissue trauma.
Because the laparoscopic method is less disruptive than open surgery, it comes with a smaller risk of complications, a faster, less painful recovery, and minimal scarring.
Dr. Serrano has also developed an even more advanced approach to gallbladder removal: the ultra-minimally invasive (UMI) cholecystectomy. By combining laparoscopy and robotics, this exceptionally precise, high-tech procedure provides a superior cosmetic outcome with less risk.
Life without a gallbladder
After gallbladder surgery, your liver continues to produce enough bile to digest the fats in your diet. But instead of storing and concentrating that bile in a “gallbladder pouch,” your liver drips it directly into your digestive tract.
As your small intestine gets used to the direct flow of bile from your liver, you may experience loose, watery stools for a few weeks or even a few months. Switching to a low-fat diet can help your small intestine experience a smoother transition that’s easier on you, too.
You can lead a perfectly normal life — and maintain good health — without your gallbladder. In fact, your health may even improve if post-surgical dietary recommendations compel you to cut fatty fried foods and high-fat processed meals from your diet for good.
To learn more about minimally invasive gallbladder removal at Precision Surgery and Advanced Vein Therapy in Glendale, Arizona, call 602-393-1304 today, or use the easy online tool to book a consultation with Dr. Serrano any time.
Warning Signs You May Need Your Gallbladder Removed
The human body contains a few organs that may leave you scratching your head as to their purpose. Why do we have an appendix or wisdom teeth for instance? Science refers to these as vestigial organs, meaning that while they were once useful, they serve no purpose to humans today. Then, there are organs such as the gallbladder that are a step above vestigial organs in their function but which the body can still function just fine without.
What is the Purpose of the Gallbladder?
The gallbladder’s role is in digestion, and while it does serve a purpose, it isn’t essential. This small, pear-shaped organ is located just below the liver. It stores small amounts of bile that are released into the small intestine after eating to aid in the digestion of fats. However, it can also become the source of painful and troublesome symptoms should it become inflamed or develop gallstones.
Symptoms of a Gallbladder Problem
The primary source of problems within the gallbladder, including inflammation, stem from the development of gallstones. These hard deposits of digestive fluid can occur in the gallbladder itself or in the bile duct, and they can range in size from as tiny as a grain of sand to as big as a golf ball. Some patients may only develop a single gallstone, while others will have several. However, it is not the presence of gallstones but the complications they cause that may necessitate surgery. When these deposits develop and cause a blockage in the bile duct, the bile is unable to circulate out of the liver as normal, building up and resulting in painful inflammation in a condition known as cholecystitis. The symptoms associated with the condition include:
- Sudden and severe pain at the upper right or center abdomen
- Tenderness of the abdomen
- Pain after eating
- Nausea and vomiting
If left untreated, the complications could lead to an infection or even cause the gallbladder to tear or burst.
What Can You Expect from Gallbladder Surgery?
If gallstones have been identified as the source of your symptoms, treatment options could include dietary changes and medications to dissolve existing gallstones or prevent the development of new ones. However, surgical removal of the gallbladder (cholecystectomy) is the most common treatment. Fortunately, the procedure is common and has minimal risk of complications. Most frequently, it is performed on an outpatient basis using minimally invasive laparoscopic techniques.
After the procedure, patients are generally able to go home the same day, barring complications. Full recovery may take up to a week, and most can return to normal activity within a few days. While digestive complications following the surgery are rare, some patients experience side effects such as loose stools that tend to resolve over time.
If you have been experiencing symptoms associated with gallstones, do not put off a visit to your physician. It is unlikely that the condition will resolve on its own. In fact, it may worsen and lead to more severe complications down the line. Gallbladder removal is not only simple, but it is also highly effective at alleviating symptoms once and for all, allowing patients to once again eat and function without discomfort.
The team at Lane Surgery Group perform cholecystectomies regularly and with great results. Click below to learn more about our team and facility.
Life After Gall Bladder Removal
If you experience persistent and severe abdominal pain from gallstones, your doctor may recommend to have your gall bladder removed. Speak to your doctor to discuss your surgery options, or make an appointment with a specialist.
Here, we look at some burning questions you may have about gall bladder removal and life after surgery:
What does my gall bladder do?
Your gall bladder is a small organ connected to the liver. It stores bile from the liver before it is released into the small intestine. Bile helps your body break down food and digest fat.
Why is gall bladder removal necessary?
Your doctor may recommend gall bladder removal, known as a cholecystectomy. It is generally for symptomatic gallstones. Gallstones may cause pain, infection or obstruction.
Can I function normally without a gall bladder?
Yes, you can. Without your gall bladder, bile flows directly into the small intestine. This may stimulate the intestine and 50% of patients may experience loose motion. This symptom will usually last for only 3 – 6 months. If it happens, stay on a low-fat diet to help with the loose motion. After 3 – 6 months patients will return to their normal status.
Is my life expectancy affected?
Gall bladder removal doesn’t shorten your life expectancy. In fact, it may even increase it as your post-surgery habits ‘force’ you to make healthier dietary choices. By eating smaller amounts of fats, oils, dairy products, and processed foods, you lose weight and reduce your risk of developing conditions such as high blood pressure, heart disease and diabetes. As you are also taking in fewer calories per day, your body will digest your food and use energy more efficiently.
Will I have to make any dietary changes?
Your body will have to adjust to having no gall bladder, so, in the months after your operation, you can test your limits to work out what kind of food work best for you. The good news is that the changes you make will encourage you to lead a healthier lifestyle.
Here are some tips:
Limit your fat intake
Fat is going to be an issue so you need to know what you are putting into your body and how much of it is hidden fat. Read food labels and avoid processed food when you can. Eating whole foods eliminates the guesswork from your meal plans. Choose boiled or grilled food over fried and opt for low-fat choices when it comes to milk and cheese. Fat should make up only 30% of your diet.
Take frequent but smaller portions throughout the day
Your digestive system works slightly differently now so overwhelming it with too much food in one sitting puts too much strain on your liver and it can’t produce the amount of bile needed to help your body digest the food. Divide your meals into smaller dishes every day that include lean meat or other non-processed protein sources and fruit and vegetables.
Reduce the amount of fibre you take in
In the initial months after your surgery, you may find that eating foods high in fibre causes bloating, pain and diarrhoea. Limit your intake of offending foods like cauliflower, cabbage, beans, nuts, cereals and bread and introduce them slowly back into your diet one at a time until you can work out your limits.
Reduce your caffeine intake
Caffeine increases the production of stomach acid, which makes your stomach contents empty faster. Without the normal amount of bile in your stomach that used to be produced by your gall bladder, you will experience more gas, bloating and pain as the food is digested. Start to introduce coffee and tea back into your diet gradually to see how much you can handle.
Record what you eat
Being more aware and mindful of what you are eating is going to help you recover faster and return to life as normal. Record your food intake, breaking down each ingredient and how much you eat, and note the side effects that come up. Look for patterns so you can moderate your diet accordingly. This will help you to avoid or limit foods that you now know cause problems.
In summary, your body can still function well without your gall bladder. Be mindful, though, to control your diet to avoid or limit food that will cause digestive issues – introducing these healthy dietary habits into your lifestyle post-surgery will also benefit your overall health in the long run!
If you’re worried about the cost of surgery, Gleneagles Hospital offers price guarantee for your gall bladder removal surgery so you can budget for the procedure without any bill shock afterwards. This will give you the peace of mind you need to go ahead without any unwanted surprise fees. Learn more about Price Guarantee Procedures.
The improvement on your quality of life can be dramatic, so it’s important to prioritise treatment if you need it.
Article reviewed by Dr Winston Woon, general surgeon at Gleneagles Hospital
Jewell, T. Can you live without a gallbladder. 17 April 2018. Retrieved 11 April 2019 from https://www.healthline.com/health/can-you-live-without-a-gallbladder#life-expectancy
5 ways to avoid discomfort after your gallbladder removal. 29 July 2015. Retreived 11 April 2019 from https://health.clevelandclinic.org/5-ways-to-avoid-discomfort-after-your-gallbladder-removal/
How to live fully without a gallbladder
When lard is a cult product, and dumplings are eaten with cracklings and peasant sour cream, it is not surprising that after 35 years the word “cholecystectomy” appears in the medical records of Ukrainians. The gallbladder is removed for various reasons, but mainly due to stones. They can be of a different nature and origin, but most often they appear from malnutrition. From fatty foods and cholesterol, the composition of bile changes, the outflow becomes more difficult.Gallstones are formed. After the turning point – when such a stone clogs the duct, causes pain and leads the patient to surgery – the gallbladder is removed.
Why bile is needed at all
Fat does not dissolve in water – an axiom. Man is mainly water, and all processes in cells take place in aqueous solutions. Therefore, in order for the fats of food to be digested, they must be broken into small drops. This is the mission of bile in the digestion process.
Bile is excreted by the liver. Together with the bile, all the toxins that were there for neutralization are released. In order to break down fat into droplets as efficiently as possible, bile is accumulated in a sac – the gallbladder, and is released into the intestines only when necessary – when the next portion of food arrives. This is the easiest way for the body to deal with fats in the food we eat.
How digestion will change after removal of the gallbladder
Bile will be secreted by the liver as before, but there will be no place for its collection.A portion of fatty foods will not be processed properly. But our body is very flexible, and relatively quickly the liver will adapt to secrete bile in proportion to its needs. If you help her with this – eat small portions of warm, mostly pureed food – you will not notice any changes or inconveniences.
How to eat in the first days after surgery
A person without a gallbladder can live a fulfilling life with reasonable dietary restrictions. Of course, immediately after the operation, you must adhere to a diet, but after six months you can start eating ordinary healthy food.
Cool tip: We traditionally think of therapeutic diets as limitations. And when the doctor lists the forbidden “snacks” – it seems that the world has turned upside down. In fact, it is much easier to stick to a proper diet if you focus on what is permitted. Therefore, immediately after removing the gallbladder, you can form a menu from the following products:
– vegetables and fruits, the first few weeks in the form of a smoothie;
– low-fat varieties of fish, steamed;
– boiled meat;
– whole grain cereals;
– healthy vegetable oils.
How to form a diet a year after surgery
Give preference to a healthy diet – whole grains (cereals, bran bread), proteins (eggs, lean meat, legumes), vegetables and fruits, dairy products, healthy oils (flaxseed, sesame, pumpkin seed oil, milk thistle oil, etc.) .). Eat more often – plan 5-6 small meals a day instead of a hearty breakfast and heavy dinner. Try to keep food (especially food containing fat) warm – cold fat is much harder to break down into small, digestible droplets.
How to avoid relapse
The absence of a gallbladder does not exclude the re-formation of gallstones. That is why, in addition to regularly eating small portions of healthy food, the intake of natural choleretic agents should also be added to new habits. If a relapse is obvious, the doctor will prescribe synthetic choleretic agents, but it is not worth bringing to this. Add to the diet choleretic drugs of natural origin, infusions and teas from herbs – tansy, milk thistle, cmin (immortelle), barberry, etc.When choosing such fees, you should consult your doctor.
Milk thistle oil is a mild natural remedy for stimulating the outflow of bile. It contains an active substance – silymarin, a natural hepatoprotector (“protector” of the liver). In addition to the choleretic effect, milk thistle oil stimulates the excretion of accumulated toxins from the liver along with bile.
The absence of a mechanism conceived by nature still leaves an imprint on the way of life. However, the changes are insignificant – it is enough to eat healthy food and use healthy vegetable oils.
90,000 How to live after removal of the gallbladder / Health / Nezavisimaya gazeta
The first year and a half are the most difficult, even in a psychological sense
One of the main conditions for recovery from gallbladder surgery is proper diet. Pexels Photos
The operation to remove the gallbladder is called cholecystectomy in medicine. This is the most common abdominal surgery after the appendix is removed.Most often, cholecystectomy is resorted to in case of dysfunction of the gallbladder as a consequence of gallstone disease. In this case, the formed stones or sand impede the outflow of bile from the bladder, which is often accompanied by severe pain and fraught with serious complications.
If therapeutic methods are powerless, surgery is indicated. Currently, it is mainly performed by the laparoscopic method using a special device inserted through a puncture in the abdominal wall.Performing this low-traumatic operation, the surgeon dispenses with traditional incisions, which makes it possible to shorten the patient’s stay in the hospital. After removing the gallbladder, the body gradually adapts to the new digestive conditions.
It is known that bile is produced by liver cells and enters the gallbladder. Here, as a result of chemical changes, its concentration increases, it thickens, becomes more viscous. After eating, bile from the gallbladder is directed through the ducts into the duodenum and promotes the digestion and absorption of fats.But what if the bubble is removed? In this case, bile enters the intestine immediately. This can lead to complications.
The fact is that in the absence of a gallbladder, the concentration of bile is lowered, it becomes chemically less aggressive. As a result, favorable conditions are created for the activation of pathogenic microorganisms. Against this background, the operated person may, for example, experience duodenitis (inflammation of the duodenum), duodeno-gastric reflux (throwing food from the duodenum back into the stomach), gastritis (inflammation of the gastric mucosa) or other diseases of the digestive system.
Fortunately, the body’s compensatory capabilities are great, and such complications after removal of the gallbladder are not so common. In addition, diet plays an important role in their prevention – the main therapeutic factor contributing to recovery. One of its main requirements is that food should be taken in small portions, five to six times a day. This is necessary so that bile, which is released into the intestines only after a meal, does not stagnate in the biliary tract.
What should be the diet for people who have undergone surgery? First of all, it is necessary to exclude from it spicy, fried, smoked, canned food and various spices. Dishes from fatty meats and fish, coarse bread, pastries with cream, alcoholic and carbonated drinks, coffee, strong tea are contraindicated. The list of prohibited foods also includes sour berries and fruits, peas, beans, onions, and garlic. Cold food contributes to cramps in the gastrointestinal tract, so another requirement is that the food must be warm.
It should be especially emphasized that preference should be given to steamed foods, as well as boiled and stewed foods. This will avoid unwanted irritation of the mucous membranes of the digestive organs and will help them to more easily and quickly adapt to new conditions. As for the menu, let’s say it’s good to cook an omelet, rice or oatmeal for breakfast. The morning menu can also include low-fat cheeses, low-fat cottage cheese and sour cream, vegetable puree, boiled vegetables, and from drinks – weak tea.
For lunch, vegetable, cereal or milk soups are recommended from the first courses, and from the second – steam cutlets, roll or meatballs made from low-fat varieties of beef, fish or chicken. Vegetable puree, buckwheat porridge, pasta are allowed as a side dish for the second courses. As for the bread, it should only be white and yesterday’s baked goods. And for dessert – compote, jelly or fresh fruit, but always sweet. In the afternoon snack menu, it is advisable to include kefir with a bun or with low-fat cookies.And for dinner, cook buckwheat porridge, cottage cheese casserole or stewed vegetables.
During the year after surgery, heavy physical activity is contraindicated, especially associated with tension in the abdominal muscles. This can lead to the formation of a postoperative hernia. But morning exercises, light exercise are useful, since they activate the work of the digestive system and facilitate the passage of bile. It is possible to start them in agreement with the doctor one and a half to two months after the operation.Of course, if you feel good. Walking is also recommended to help combat bile congestion.
Life after removal of the gallbladder (cholecystectomy) / Gastrocenter EXPERT
Frequently asked questions
Do disability after removal of the gallbladder?
According to the criteria established by the medical community, the absence of a gallbladder itself is not an indication for assigning a disability, because it does not interfere with work and mental activity.In the event that the patient’s work is associated with heavy physical labor or high mental and emotional stress, he may be recommended to facilitate working conditions.
Disability after removal of cholecystectomy can be attributed if complications occur during or after surgery.
To obtain a disability group, you must apply for a medical and social examination (ITU).
Can the liver hurt after removal of the gallbladder?
The liver itself does not hurt – there are no nerve endings responsible for the feeling of pain in it.If you are experiencing pain and discomfort in the right hypochondrium, this is probably the aftermath of gallbladder surgery, which should go away within a week.
If the symptoms persist, this may indicate the development of postcholecystectomy syndrome (PCES), with which it is recommended to consult a gastroenterologist.
Is it ok to have sex?
Sexual activity, like sports, is characterized by a wide range of possible physical and physiological stresses.After successful completion of postoperative recovery, patients can return to normal sex life. However, it should be remembered that certain positions during intercourse, involving lifting a partner or squeezing the abdominal area, should be used carefully and within reasonable limits.
Is it possible to carry a pregnancy after removing the gallbladder?
Planning a pregnancy should not be earlier than 3-6 months after a successful operation. During this period, the body will restore strength and it will become clear whether there are negative consequences after the intervention.
In any case, pregnancy, childbirth, hormonal changes are risk factors for the formation of new stones. During and after gestation, it is necessary to pay special attention to the nutrition of the expectant mother, it is advisable to be under the supervision of a gastroenterologist and a nutritionist, to do preventive ultrasound of the bile ducts.
Is it ok to lift weights?
This primarily depends on the type of operation performed. With less invasive laparoscopic gallbladder removal, the restrictions on weight lifting in the postoperative period are less significant: do not lift weights above 9-10 kg in the first 4-6 weeks.For open surgery to remove the gallbladder, the weight limit is 5-6 kg.
After the end of the recovery period, you can try to lift more significant weights, but you need to listen to your well-being. If you feel discomfort in the abdomen, then you should stop lifting weights and consult a doctor.
Is a cold immediately after surgery dangerous?
A common cold, acute respiratory infections or acute respiratory viral infections can affect any person, and the patient’s body after removal of the gallbladder is especially vulnerable, since his immunity is reduced in the first weeks after surgery and general anesthesia.That is why, for the prevention of colds, it is important to avoid hypothermia, drafts and follow the regimen prescribed by the doctor.
The danger is that some people may develop postoperative pneumonia after surgery. The symptoms of this disease in the initial stages resemble the common cold. If symptoms similar to a cold occur after the operation, but then the temperature rises significantly (above 38 ° C), you should immediately consult your doctor.
The same should be done in cases when the temperature of 37.1-38 ° C lasts for several days or colds symptoms gradually worsen.
Is it possible to take hot baths, go to the bathhouse and when?
An increase in body temperature in a hot bath or steam bath increases blood flow and inflammation, if any. You can wash in warm and hot water 3-4 weeks after removing the stitches – with care, not being exposed to high temperatures for longer than necessary.
You need to be careful:
- warm up only until the first sweat
- control your well-being
- prefer a wet bath to a dry sauna.
Can I smoke and drink alcohol after removing the gallbladder?
Try to give up cigarettes, or at least reduce their number as much as possible. Nicotine is one of the factors in the formation of new stones in the bile ducts. In addition, immunity is weakened after any surgery, and the risk of complications becomes higher.To avoid postoperative pneumonia, smokers are advised to stop using nicotine products, including gum and nicotine patches, at least two weeks before surgery.
The same applies to the consumption of alcoholic beverages. Drinking alcohol during the postoperative recovery period can lead to an increased risk of complications such as diarrhea, increased liver enzymes in the blood, and slower recovery.
How does the lifestyle change after removal of the gallbladder?
The lifestyle does not change dramatically after the recovery period, therefore after 1 month, as well as after 2, 3, 4, 5, 6 months, after a year or two, the main thing is to adhere to the general recommendations.
Major changes after cholecystectomy focus on diet and exercise. They should be gentle and introduced gradually and carefully. In case of alarming manifestations, you should immediately consult your doctor. It is a good idea to keep a diary that can be used to track the body’s response to specific innovations.
It is important not to spur the body, but gradually and carefully introduce new elements into your routine that heal and strengthen the body in new realities. It is useful to actively practice the most gentle and harmonious sports that improve metabolism and reduce stress (yoga, Nordic walking, swimming). The digestive system is sensitive to stress levels, so it is important to avoid extreme emotional stress, master various methods of protection against overwork (autogenous training, breathing techniques) or seek help from a psychotherapist.
How to determine the stagnation of bile in the body
Probably, everyone is familiar with the sensation: eat a piece of fatty food, but the feeling remains that you have overeat.There is heaviness in the right side, food, it seems, is not digested for a long time. This is one of the symptoms of bile stagnation.
Together with specialist in preventive medicine Ekaterina Stepanova, Sputnik analyzed the main signs of trouble in the gallbladder and found out how it can be treated.
Signs of bile stagnation:
- aching and pulling pain in the right side after exercise;
- sensation of discomfort in the right side – as if there was something interfering or squeezing;
- pain on the right when bending and turning;
- when sitting for a long time in the wrong posture, the right hand begins to ache, pain appears in the right shoulder blade;
- dry or bitter mouth, slight changes in skin tone.
Bile stagnation, harmless at first glance, can turn into a big trouble.
Cholestasis (stagnation of bile) ranks third among diseases and pathologies of the digestive tract and is getting younger from year to year.
It affects people of retirement age, women over 40, pregnant women, office workers and schoolchildren (long restriction in movement and improper posture at the desk).
Bile is a product of the secretion of liver cells. It is produced in the liver, then through the hepatic and bile ducts it enters the gallbladder, where it accumulates.As soon as food has entered the oral cavity and the process of digestion has begun, bile enters the intestine (duodenum), where it neutralizes the remains of hydrochloric acid, breaks down fats (emulsifies to the desired condition so that they can be absorbed into the blood), helps the body absorb fat-soluble vitamins A, E, D, K, disinfects food and removes excess pathogenic bacteria in the small intestine, participates in other enzymatic reactions for complete digestion of food and assimilation of nutrients.For example, it activates lipase (pancreatic enzyme).
When digestion does not occur, bile accumulates in the gallbladder, a small pear-shaped organ located at the right intercostal arch.
If bile for any reason stagnates and does not enter the intestines, this leads to disruption of the entire digestion process. Cholestasis can lead not only to a dysfunction of the gastrointestinal tract, but also serious diseases associated with metabolic disorders: vitamin deficiency, osteoporosis, cholelithiasis, cholecystitis, in severe cases – cirrhosis of the liver (accumulation of bile, its increased concentration changes and processes liver cells) , and can also cause the formation of diabetes.Therefore, this state cannot be triggered.
To prevent stagnation of bile
The stagnation of bile is partly promoted by the liver itself, which produces bile, and the ducts along which it moves, and the gallbladder.
To avoid problems, bile should always be liquid, not viscous or jelly-like.
Bile is a highly concentrated secretion, when it is immobile for a long time, a sediment begins to form, first in the form of flakes, then they form stones.Do not forget that bile is secreted at every meal and the role of proper regular nutrition is very important in the prevention of stone formation!
The movement of bile is carried out along the ducts surrounded by muscles. It will not be superfluous to remember that any stress leads to spasm, including muscle spasm, which can lead to a banal clamping of the ducts themselves and their inlet and outlet sphincters. Bile can get stuck in the ducts. Therefore, eating should always be in a calm atmosphere and in the correct posture: give yourself pleasure – have breakfast, lunch and dinner beautifully!
Why is bile so important to us?
One of the important functions of bile is the removal of toxins and heavy metals from the body.Everything that the liver considers harmful and toxic in the process of purifying the blood, it dumps into bile, and the latter physically removes it from the body through the intestines.
Lack of bile prevents fat-soluble vitamins from being absorbed, no matter how much you take.
When, due to stagnation of bile, there is a shortage of it, the body cannot fully assimilate fat, the mechanism of selective absorption of food is triggered, that is, an imbalance arises artificially towards a low-fat diet.This forces the liver to convert excess carbohydrates into fat, and the body stores it strategically, so when you are struggling to lose weight and there are no results, check your gallbladder.
Bile, among other things, converts fats into energy – when there is not enough bile, the body also lacks energy for its vital activity, and in particular for the work of the brain. Over time, bile stasis can even lead to brain dysfunction and senile dementia.
The bile ducts and pancreatic ducts exit into the duodenum.
It is better not to eat in a state of stress – in a spasm, the common bile duct blocks the output of pancreatic juice, which leads to self-digestion of pancreatic cells and damage to Langerhans cells that produce insulin, which is a prerequisite for the development of diabetes mellitus. Lack of bile can provoke surges in blood sugar and insulin.
Bile is needed for the active work of the thyroid gland, since along with the digestion of fats, the body produces an enzyme that converts the inactive form of the hormone T4 into active T3!
Also, bile is actively involved in the synthesis and transformation of sex hormones, therefore, for any problems in this area, it is worth starting with an examination of the liver and gallbladder.
Formed bile stagnation can be recognized by the following signs:
- dull pain in the right hypochondrium;
- frequent belching;
- enlarged liver;
- dark urine and light stool;
- constipation or diarrhea;
- bad breath;
- chronic fatigue, drowsiness;
- bitterness in the mouth;
- persistent itching of the skin;
- yellow color of the skin and whites of the eyes.
At the first sign of stagnation, it is better to immediately do an ultrasound.If you feel unwell, you should consult a doctor. With prolonged stagnation, both sand and stones in the gallbladder can form, and with any stimulation of the movement of bile, the movement of stones can also be provoked. If the stone is small, then, although with pain, it will come out of the duct, and a large one is able to clog the duct. And in this case, an emergency operation is indicated.
Examination and treatment for stagnation of bile
An additional examination is required for an accurate diagnosis:
- Ultrasound of the liver and bile ducts.It will help assess the extent of the lesion and the presence of stones. The presence of a bile sediment will indicate that the bile is thick and viscous, it is difficult to move along the bile ducts, and therefore may stagnate. The accumulation of bile in the ducts causes the liver to increase in volume.
- General blood and urine tests will help assess the general condition of the body.
- Blood biochemistry will give a complete picture of the work of the liver and gallbladder.
- Analysis of bile will determine its composition.
- Coprogram will help to assess the work of the intestines, as well as the quality of the digestive process.
After all examinations, the doctor will prescribe treatment. This is easily corrected in the early stages.
For prophylactic purposes, it is useful to make a blind tubage, it brings relief, to drink choleretic herbs or preparations and add foods with a mild choleretic effect to your diet (bitterness, herbs, coarse fiber).
Remember that stagnation of bile is in most cases a problem created by a person’s lifestyle, and it has its own prerequisites (inappropriate nutrition, stress, lack of exercise …).Have fun with life, clean up the premises and live healthy!
90,000 with and without him “
Etude of Dr. Ivanov on the gastrointestinal tract: on gallstone disease and cleansing the liver according to Malakhov. Part 4
In previous articles on digestion, the candidate of medical sciences, osteopath Alexander Ivanov spoke in detail about various diseases – gastritis, flatulence, constipation, etc. In a new article, the doctor will talk about the role of the gallbladder in our body, about the appearance in it stones and other diseases, about tubing and massage of internal organs.
A FEW WORDS ABOUT THE LIVER
The liver is the biochemical laboratory of our body. One of its important functions is detoxification, that is, neutralizing toxins (substances foreign to us) – hormones, antibiotics, drugs, alcohol, heavy metals that enter our body from the external environment (food, water, air). In addition, the liver is involved in digestion, producing bile, as well as in almost all types of metabolism (protein, fat, carbohydrate, mineral).
It is no coincidence that in many traditional healing systems (for example, in Ayurveda and Chinese medicine), the liver is assigned the main role in maintaining human health. Thus, the role of the liver can hardly be overestimated.
GALL BLADDER – A FAITHFUL FRIEND AND LIVER ASSISTANT
The gallbladder is a faithful friend and helper of the liver. The latter can produce up to 600 ml of bile per day, and the gallbladder, which is a bag with a volume of 70 – 80 ml, essentially stores this bile.
During fasting, the gallbladder is able to absorb (suck) up to 90% of the liquid component of bile, concentrating and preserving it. Eating food stimulates the gallbladder, and bile begins to flow into the lumen of the duodenum (part of the small intestine), participating in digestion.
HIPPOCRATES ABOUT BILD, OR WHY DO WE NEED BILD?
Bile is produced by the liver and is, on the one hand, an emulsifier (solvent) of fats, and on the other, that cleansing medium with which the liver and our body get rid of substances we do not need – toxins (cholesterol, antibiotics, heavy metals, hormones, alcohol ).
In terms of chemical composition, bile consists mainly of water and electrolytes (salt), as well as organic substances (cholesterol, bilirubin, bile salts).
Even Hippocrates spoke of bile as one of the forms of the internal environment of the body. He introduced the idea of a person’s temperaments and concluded that if a person has a lot of bile, then he is prone to irritability, irascibility and anger. No wonder there is such an expression as “bilious man.” Such “bile” people are prone to heart disease and blood vessels, hypertension, strokes and heart attacks.He attributed this type of people to choleric people. With an excessive amount of “black” bile, a person is prone to apathy, depression, fears, which corresponded to a melancholic temperament.
Today, the ideas of Hippocrates, to put it mildly, are outdated, and today the temperament of a person (a type of higher nervous activity) is not determined by bile. However, from the point of view of psychosomatics, there is a grain of truth in his observations.
STONES IN GALL BLADDER
The appearance in the gallbladder of dense formations of calculi is called gallstone disease, or calculous cholecystitis.The diagnosis is made on the basis of ultrasound data. Symptoms of calculous cholecystitis: dull, aching pain in the right hypochondrium of a constant nature or arising one to three hours after eating, most often fatty, fried or smoked, while there may be a bitter taste in the mouth or a metallic taste, belching, bloating, upset stool, insomnia and irritability. Treatment of calculous cholecystitis is usually surgical. But in some cases, the treatment can be conservative – medication.For example, for small cholesterol stones, the tactic of dissolving stones with the help of bile acid preparations is used, as well as fragmentation of stones – a method of extracorporeal shock wave therapy.
CHOLELYSTONE DISEASE: WHEN TO DO THE OPERATION?
The operation to remove the gallbladder is called cholecystectomy. Previously, before the advent of endoscopic surgery, the gallbladder was removed, leaving rough abdominal scars and adhesions. At the moment, operations are less traumatic, only small punctures remain, which are hardly noticeable on the skin.
Can a person live without a gallbladder? Yes, it can, but there is nothing superfluous in the body, and the removal of the gallbladder is always a tragedy for the whole body. After surgery, dyspepsia, upset stools such as constipation or diarrhea may often appear. The pancreas and liver begin to suffer.
Among some doctors there is an opinion that if stones in the gallbladder are found, then the operation must be done, as they say, just in case of fire. However, in the Western medical literature on this issue, they say that if calculi are less than 3 cm in diameter and there are no clinical manifestations (pain), then it is not worth removing the gallbladder.Indications for removal of the gallbladder are attacks of hepatic colic (the risk of blockage of the bile ducts by a stone) and large stones (more than 3 cm) – this condition increases the risk of developing gallbladder carcinoma.
CAUSES OF CHILIAR STONE DISEASE
Gallstone disease is more common in women than in men, as estrogens (female sex hormones) play an important role here. A sedentary lifestyle (sedentary work), a violation of the diet (abuse of fatty and fried), irregular nutrition (long breaks between meals and prolonged fasting), burdened heredity – all these are risk factors for cholecystitis.
Dyskinesia (literally “movement disorder”) of the biliary tract is a violation of the outflow of bile along the biliary tract. It can be hyperkinetic (excessive tension, spasm) and hypotonic (on the contrary, contractile weakness of the gallbladder). Dyskinesia occurs most often due to a spasm of the sphincter of Oddi (the place where the bile duct flows into the intestine), with kinks of the gallbladder or in violation of the diet.The most common cause of sphincter spasm is chronic stress. Dyskinesia can cause gallstones, a gallstone disease.
Most often this disease occurs in young children due to the imperfection of their digestive system. The manifestations of dyskinesia can be abdominal pain, colic, pain in the right hypochondrium, yellow coating on the tongue, bitterness in the mouth.
In case of dyskinesia, the doctor may prescribe a fractional diet 5 – 6 times a day, choleretic drugs, antispasmodics or abdominal massage.Manual medicine methods, such as osteopathic techniques, are effective and safe.
STRAIGHT AND INDIRECT TUBE
In medical practice, there are methods of artificial drainage (removal) of bile from the gallbladder. Medical tubage (from the French word tubage “washing”) is a therapeutic and prophylactic measure aimed at removing bile from the gallbladder using choleretic agents. It can be performed using a duodenal probe (direct tubing) or without it (indirect tubing).This method is used for biliary dyskinesia, acalculous cholecystitis, inflammation of the pancreas (pancreatitis) and duodenum (duodenitis). Many sanatoriums still use this method, which is very effective for diseases of the gastrointestinal tract.
LIVER CLEANING ACCORDING TO MALAKHOV
I would like to warn dear reader against various liver cleanses according to recipes from the Internet or books of “folk healers” such as Gennady Malakhov and Andreas Morritz .Also now very popular “enema”, where for decent money you will be starved, stuffed with laxatives, do daily enemas and carry out a la tubage. All this is called cleansing the body. For me, this is complete obscurantism. I have nothing against alternative methods of treatment, but I am for a reasonable approach to each person. The methods of Ayurveda, therapeutic fasting, unloading and dietary therapy have a place to be, but only under strict medical supervision and in the hands of professionals.
MASSAGE OF THE INTERNAL ORGANS, OR HOW CAN OSTEOPATHY HELP IN DYSKINESIA?
In the arsenal of modern medicine there are safe, but effective methods of eliminating functional problems – dysfunctions of internal organs, including the gallbladder. An osteopathic doctor, with the help of his sensitive hands, will diagnose and identify areas of restriction and tension of internal organs. With the help of his hands, the doctor will delicately relieve the spasm, drain the bile and restore the work of the gastrointestinal tract.Such gentle osteopathic techniques are suitable for both young children and adults with gallbladder problems. The duration of a session with an osteopathic doctor takes no more than one hour, the frequency is on average one session per week. The course of treatment can last a month.
1. The liver produces bile and stores it in the gallbladder. At the time of eating, bile is secreted into the intestines and breaks down fats.
2. The gallbladder is an important organ, without which our body begins to ache.
3. The formation of stones in the gallbladder is not always an indication for surgery.
4. Regular and balanced nutrition, regular physical activity and drainage of the biliary system are effective measures for the prevention of gallstone disease.
5. Tyubage (direct and indirect) is a medical procedure, and it is not safe to carry out it yourself at home.
6. Cleansing the liver using folk methods is often harmful to health.
7.Dyskinesia (impaired outflow of bile) is of a functional (emotional) nature and is usually associated with spasm of the muscular sphincter. Manual treatments such as osteopathy are effective in treating dyskinesia.
The opinion of the author may not coincide with the position of the editors
90,000 Gallstones: Should I Operate?
– How do stones form in the gallbladder, and to what size can they grow?
– What methods are used to treat gallstone disease?
– In what cases is it better not to touch stones in the gallbladder, and when is the operation necessary?
These and other questions will be answered by surgeon of the first qualification category, candidate of medical sciences, associate professor of the Department of Surgical Diseases of the Medical University “Reaviz” Igor Valerievich Ishutov.
Write your questions in the form below .
What can you eat with a disease of the bile ducts?
Doctor-surgeon of the first qualification category, Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases of the Medical University “Reaviz” Igor Valerievich Ishutov
Good afternoon. To answer this question, you need to know the exact diagnosis. For different diseases, there may be different diet options. I recommend consulting a surgeon or gastroenterologist.
Hello, I did an ultrasound scan during pregnancy for 22 weeks. Found stones in the gallbladder. As long as they do not bother me. Is it possible to start treatment now or is it better to do it after giving birth?
Doctor-surgeon of the first qualification category, Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases of the Medical University “Reaviz” Igor Valerievich Ishutov
Good afternoon! You did not indicate how many stones and what size they are. But if the stones do not bother, then I recommend repeating the ultrasound after childbirth and contacting a surgeon who will prescribe treatment.
Good evening! A stone 8.5 mm in size was found in my gall. Periodically, the right side hurts under the rib. How can it be cured? Is it worth using folk methods?
Doctor-surgeon of the first qualification category, Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases of the Medical University “Reaviz” Igor Valerievich Ishutov
Good afternoon! You need to go to an appointment with a gastroenterologist, who will prescribe litholytic therapy aimed at dissolving the stone.If there is no effect within 6 months, then – surgical treatment.
Good afternoon! We live in Volgar, we have very bad water, after this water there is a white coating on the dishes. I am worried that this may affect the health of the gallbladder. Tell me, bad water only almost affects or bile too. I used to have problems with the gallbladder, I am worried that after moving to a new area, these problems will return.
First qualification category surgeon, Ph.MD, Associate Professor of the Department of Surgical Diseases of the Medical University “Reaviz” Igor Valerievich Ishutov
Hello! The composition of the water we drink primarily affects the gastric mucosa, and then the kidneys. If you have had any problems with the gallbladder before, then I recommend doing an ultrasound of the abdominal cavity.
Hello. At the age of 7, a stone was found in the gallbladder 0.4 cm in size, they tried to dissolve with drugs as prescribed by a doctor, but to no avail.The stone did not bother me, I periodically underwent ultrasound and FGDS. At the moment I am 27 years old, the stone has grown to 2.2 cm, but everything is still in order. For 20 years, I have adhered to the rules not to eat spicy, fatty and fried foods, to follow at least some kind of diet. One question worries: is it possible to live with him if he does not bother him and if his presence will not lead to other, side diseases? Thanks in advance.
Good afternoon! A stone measuring 2.2 cm is considered large.Its presence in the gallbladder constantly maintains inflammation in its wall. It is possible to live with such a stone in the gallbladder, BUT in the presence of provoking factors – intake of fatty foods, alcohol, physical activity – an attack of acute cholecystitis may develop, which may require emergency surgery. Unfortunately, following a diet does not guarantee 100% future seizures. In addition, other complications may develop – obstructive jaundice, inflammation of the bile ducts, acute and chronic pancreatitis, and even gallbladder cancer.It is impossible to completely cure chronic cholecystitis in the presence of gallstones. In your case, the only way out is routine surgical treatment. The “gold standard” is now a low-traumatic laparoscopic cholecystectomy performed through small punctures. 6 months after the operation, it will be possible to completely abandon the diet and simply adhere to the correct diet.
How do stones affect sex life?
First qualification category surgeon, Ph.MD, Associate Professor of the Department of Surgical Diseases of the Medical University “Reaviz” Igor Valerievich Ishutov
Good afternoon! Gallbladder stones do not affect sex life.
They found a stone in my gallbladder. 2 cm long, 1.5 wide. And a few more small stones. Doctors insist on removing the gallbladder. Tell me, is there any way to save my gallbladder? At the same time, painful attacks very much interfere with living and working.
First qualification category surgeon, Ph.MD, Associate Professor of the Department of Surgical Diseases of the Medical University “Reaviz” Igor Valerievich Ishutov
Good afternoon. Unfortunately, stones in the gallbladder cannot be crushed and stones of this size cannot be dissolved. It is impossible to completely cure chronic cholecystitis in the presence of gallstones. In your case, the only way out is surgical treatment. The “gold standard” is now a low-traumatic laparoscopic cholecystectomy performed through small punctures.It is better to perform the operation in a planned manner than to wait for the next attack, which may result in an emergency “abdominal” operation. Moreover, seizures interfere with living and working.
Hello, my husband had problems with the gallbladder in childhood (obstruction of the bile ducts, it seems). Then they dealt with this problem. Now he often has pains, as he says – his stomach, once from the pain he lost consciousness for a couple of minutes. About three months ago, an unpleasant odor appeared from the mouth.After smoked bacon, he was ill as if he had been poisoned. (Although I ate the same thing and felt good) After almost a week of fasting, I began to feel better. It seems to me that this is how the gallbladder reacts. Tell me, are my suspicions justified?
Good afternoon! It is not clear from your question how you dealt with the problem of your husband in childhood.Was there an operation or not? I recommend doing an abdominal ultrasound and consulting a surgeon.
My question is this: Recently I noticed that I had some kind of unpleasant taste in my mouth, after eating I feel a heaviness in my right side under the ribs. It is especially unpleasant after fried, fatty or spicy food. After smoked sausage, I generally died. And after alcohol, even if I drink a little. My wife assures me that this is a gallbladder, and that I urgently need an ultrasound scan. Tell me, can these symptoms really indicate problems in the gallbladder? Which specialist is better to contact? See a therapist first?
Good afternoon! The complaints you describe may indicate problems with the liver, gallbladder or duodenum. Listen to your wife. You need to undergo an abdominal ultrasound and EGD. To do this, contact a therapist who will refer you for an examination. You can also contact us to perform this examination at the Reaviz Multidisciplinary Clinic. If an ultrasound scan reveals stones in the gallbladder, then you need to contact a surgeon.If there are no stones, then to a gastroenterologist.
Good afternoon! My grandmother found stones in the gall – 22 mm. She is 76 years old, not sure that the operation will go without serious consequences for her. Tell me if there are other ways to remove the stone. Maybe there are some medications that dissolve the stones? Or it is better not to touch it at all.
Good afternoon! Unfortunately, stones in the gallbladder are not crushed and a 22 mm stone cannot be dissolved.Today, age is not an indicator of health. I recommend consulting a surgeon, he will prescribe certain examinations to determine the risk of surgery. In the conditions of modern high-quality anesthesia, a low-traumatic laparoscopic operation is quite safe. We operate on patients at both 80 and 90 years old.
Good afternoon! A couple of days ago I did an ultrasound scan, they found a stone at the bend of the gallbladder. the size of the stone is 1.7 by 2.2. Tell me, is such a stone considered large? Is surgical intervention necessary in this case?
Good afternoon! A stone measuring 1.7 * 2.2 cm is considered large enough. The presence of any number of stones in the gallbladder constantly maintains inflammation in its wall. In the presence of provoking factors – the intake of fatty foods, alcohol, physical activity – the inflammation is exacerbated, and an attack of acute cholecystitis develops, which may require emergency surgery. It is impossible to completely cure chronic cholecystitis in the presence of gallstones.Dissolving a stone of this size will not work exactly, therefore, in your case, the only way out is surgical treatment. The “gold standard” is now a low-traumatic laparoscopic cholecystectomy performed through small punctures.
Stones in the gallbladder: surgery or pills?
The program “Medicine of the Future” is on the air.Its hosts are Oleg Druzhbinsky and I, Anastasia Udilova. The topic of today’s show: “Stones in the gallbladder. Who should I run to: a therapist or a surgeon? ” Our guest today is Maxim Vyacheslavovich Vasiliev, Candidate of Medical Sciences, surgeon, head of the surgical department of the Moscow City Clinical Hospital. F.I. Inozemtseva.
Thank you very much for coming to us today! Because I have a feeling that almost all men have gallstones, sorry for such a statement.Especially in people who like to live, they are a little overweight or, say, dignified, they must have stones in the gallbladder. Tell me from the very beginning, what are the predispositions for the appearance of stones?
The gallstone disease, which we will talk about today, was called the disease of society and the disease of satiety, the disease of affluence. Than is better, not better in quality, and the more a person eats, the less he moves, the more he gets a predisposition to the disease.If in the 50s – 70s of the last century, about 10% of the world’s population were susceptible to this disease, by the end of the century the frequency of occurrence had already reached 20%.
That is, everyone who eats normally and, let’s say, in the body, will definitely arrange something similar to themselves, as they say?
In general, yes.
Tell me, have you already figured out the genetic nature of the appearance? Is there a hereditary pattern for the appearance of stones?
There are certain predispositions.For example, on the maternal side, on the female side, cholelithiasis is more common in the family, less for men. However, I, at least, have not come across reliable references to a specific gene mutation, which must be looked for, which must be caught.
Got it. That is, if a girl has a mother …
If a mother has a cholelithiasis, then in 50% of cases the daughter should be checked when she grows up.
Tell me, at what point it is already necessary to check how old a person should be, or only when it was stabbed on the right, under the ribs?
It is difficult to answer unequivocally here. If nothing hurts, then you don’t have to go to the doctor, on the one hand. If there are predispositions, again, a family history, that is, the mother, the grandmother had severe disease with complications, then it makes sense to screen.Nowadays, a powerful diagnostic apparatus such as ultrasound, ultrasound has appeared, which reveals this disease by 98%. Almost any specialist will determine whether there is a pathology of the gallbladder or not. A very simple, routine event.
That is, how the uzist made the check-up of the organism, it is immediately clear: you have a pebble lying here.
There are some horror stories that tell everyone who has found a stone; that you will fly in an airplane, and suddenly there, at a height, you begin to abuse something, and at that moment the stone closes some paths, and you can move the horses! I am speaking roughly, in slang, and you correct me, is it so or not?
I will correct: no, it is not true.Of course, an attack of biliary colic can occur at altitude, but, most often for patients who want to walk before the first attack, or until the next attack (I’m getting ahead of ourselves a little), I explain the following. Usually colic or an attack of gallstone disease begins on Friday at the dacha, when the company has already arrived at the dacha, when they have already relaxed a little, when they ate something fat, the drivers can no longer go to Moscow or to a nearby city, or a hospital, buses are no longer walk – and this is where the problems begin.
That is, they provoked something. Alcohol, barbecue?
Alcohol and fatty foods provoke, more fatty foods. Everything is very simple. Bile in digestion is needed to emulsify fat. What is emulsification? This is the transformation of large fatty formations, molecules into small, into small, small bubbles, so that the fat dissolves in water. This requires bile. Accordingly, bile is needed to digest fat.As soon as we ate a little more fatty product than usual, the liver, along with the gallbladder, begins to add bile into the intestinal lumen in order to digest everything. Digestion works like this: when a little more fat comes in, accordingly, you need a little more than what should digest it. If there are stones in the gallbladder, then they, like a cork, fly along with the flow of bile into a narrow place, into the neck, it is called the neck of the gallbladder. First, the neck, in the gallbladder itself – like a funnel. A pebble sticks in there and clogs up.But the liver, together with the gallbladder, continues to contract in order to still throw up the bile necessary for digestion, and then the gallbladder begins to press on the liquid. The fluid is not compressed, does not pass, pain appears. That’s it, the attack of biliary colic has begun.
What to do in such a critical situation? What would you suggest?
Only taking antispasmodics. Can I call?
You can name it.No-shpa, for example.
Yes, but-shpa. A really safe drug for doctors too. Why it is impossible to take painkillers, because the doctor who sees the patient may not quite understand that the person is anesthetized.
Yes, a blurry picture, it won’t hurt so much, and so on. Therefore, painkillers are not recommended to be prescribed, more precisely, they are prohibited from taking until the moment when the diagnosis is made and you are in a medical institution.Antispasmodics can be kept at home, taken for pain. If there are not enough of them, run to the doctor.
Why is this situation dangerous?
The situation is dangerous because if the gallbladder does not relax, the mechanism for the development of acute cholecystitis will start, and inflammation of the gallbladder wall will begin. Further, the process can go towards the already unfavorable one. Bile colic can still be stopped with antispasmodics, that is, you took an antispasmodic, the gallbladder relaxed, the bile flow decreased slightly, the stone floated out of the narrow neck – everything then began, so to speak, recovery.But, if everything continues, the wall of the gallbladder begins to inflame, it hurts, it hurts, swells, becomes inflamed. Then acute cholecystitis starts.
Why is this dangerous? Is this a life-threatening emergency?
This is a life-threatening emergency. If we don’t start helping us, doctors, at least everything could end badly. Bad – it means up to death.Deaths around the world with complications of gallstone disease are up to 5%.
But, this is today’s data, when are scheduled operations in mass use? That is, before in such an amount …
The mortality rate in complications is up to 5% worldwide. It is there, has not gone anywhere, and remains an urgent problem.
I want to ask a couple of clarifying questions.I have heard that it is better to have a large stone in the gallbladder than a small one, because a small one clogs up so that then nothing passes at all, and a large one moves back and forth and better. Is it so?
There is such an opinion. Relatively it is justified, I will explain why. A large stone causes complications a little less often, and they are of a different nature. The bile ducts are narrow, they are not able to squeeze out small stones. The stone, once in the duct, gets stuck, the tissue surrounding the stone swells, holds it in place, and nothing can move it from there.This already leads to life-threatening serious consequences, like obstructive jaundice. That is, bile does not flow towards the intestine. To make it clear to everyone: the liver produces up to a liter of bile per day. The pebble, which has risen like a dam, blocks the flow of bile, and the entire liter of bile remains in the liver. What happens next? Then the liver cells rupture and bile begins to enter the bloodstream. Obstructive jaundice appears next. What does it look like? A person begins to turn yellow in the literal sense, his sclera become yellow instead of white …
As with classic hepatitis.
Yes, there are some shades, but these are subtleties. The sclera turn yellow, the skin turns yellow, and, most importantly, bile enters all the organs of our body, the brain reacts especially hard to it.
Bile is toxic, it can burn out, let’s say, some cells.
Well, “burn out” is loudly said, not quite. If the situation is not resolved, then the next stage in the liver is formed abscesses, the so-called cholangiogenic abscesses, abscesses in the liver, and sepsis is triggered, which is already very close to the unfavorable outcome that we mentioned earlier.
Is it more difficult for a person to help at this stage at times?
It is many times more difficult. Additional serious methods of diagnosis and treatment are already required. If a situation develops, calculi in the gall tree, then decompression is urgently needed to relieve pressure. Now we live in an era when the methods of endoscopic decompression are very developed, when stones are removed from the bile ducts through a gastroscope, through a tube, through the stomach.Yes, there is such an opportunity. This activity is complex, not routine, not all endoscopists know this method.
I think it takes some special skill to get a pebble out of a duct.
Answer me to a fairly simple, maybe even everyday question: if a stone appears in the gallbladder, maybe just cut off the gallbladder in advance, and that’s it? And it’s easy for yourself to live, naturally, without any fear. You’ve probably heard such a question, and there is even an answer to it.
At present, a certain algorithm for the treatment of gallstone disease has been adopted. If the stone manifests itself with an attack of biliary colic, or inflammation, or pain in the right hypochondrium, sometimes pulling from a person, then we expose an indication for surgery. If this is an accidental find in a young man, an uzist saw a calculus, reported about it, then it can still be observed for some time, or treated conservatively.
We will now turn to conservative treatment, because one of the most important topics of our today’s program is to heal or cut.But, nevertheless, it is bad to live without a gallbladder if it is removed?
The situation here is very simple. The operation is not in vain called the gold standard in medicine and surgery all over the world. Why? A person adapts well to the absence of a gallbladder. Removal of the gallbladder in 90–95% of cases does not affect the patient’s later life. I have many acquaintances, my friends, who have already parted with their gallbladder. Believe me, they lead absolutely the same way of life as everyone around them.The body adapts well and tolerates the absence of the gallbladder. What is the gallbladder? This is a reservoir of spare bile. Once again, I’ll come back: the liver produces bile constantly, 0.8-1.0 liters per day, this is enough for the digestion of fat. The only limitation I tell the patient before the operation is that you cannot eat a large kebab skewer because it cannot be digested quickly. The bile will gradually leak, there will be heaviness, it will be hard. And you can afford a small one.
I have heard the following more than once: that some stones dissolve, some do not dissolve, some should be treated, some should not be treated, some should be cut immediately without waiting for the consequences. Could you explain what this is about?
In the gallbladder, 3 types of stones can form: cholesterol from cholesterol salts, age spots, bilirubin, and calcified.These are all components of bile. But, what are the more salts in bile, such stones fall out. The only species that can dissolve are cholesterol. How are they identified? They are x-ray negative. You need to take a regular X-ray; if the stones are not visible in the picture, consider that it is cholesterol.
Tell me, do I understand correctly that after you have done an ultrasound, you still need to go for an X-ray, and then you will understand whether it is worth treating it or not.
This should be done by your doctor.General practitioners, therapists, of course, know the options for conservative treatment of gallstone disease and are willing to use them, because the patient is attached for a long time. The course of conservative therapy for gallstone disease is long, ranging from six months to one and a half years. Constant intake of medicines, salt …
… ursodeoxycholic acid.
… yes, heno- and ursodeoxycholic acid, the contents of bile that make it more fluid, more liquid, and remove stones.There are limitations. It is believed that calculi up to a centimeter, according to some sources – up to half a centimeter can dissolve completely, and only cholesterol stones. But the relapse rate is between 30 and 50%
So it can start forming again?
As soon as you stop taking the drug. The main condition for conservative therapy is the preservation of the motor function of the gallbladder.Suppose a stone exists for a long time, for example, is fixed in the neck, constantly interferes with the outflow, is no longer manifested so strongly, not so brightly, almost without pain, and so on. Then the motor function of the gallbladder, its contractile ability is lost, the gallbladder turns into a bag, which … There is a term: a disabled gallbladder. It does not function, there is no point in saving an organ that is not functioning properly.
I wanted to clarify: why does it cease to function? Is the stone blocking something? It may be filled with stones.
Yes, that’s right. You can find a lot of pictures on the Internet, and I, in fact, pulled out handfuls of stones that looked like buckwheat, hazelnuts, and walnuts. Sometimes it fills the entire gallbladder, that is, it can reach 10 cm in length and 4 in width. The motor function, as I said, ceases, the organ no longer functions. When the patient asks: “But this organ is needed!” – I answer: “Oh, it is needed when it works. You don’t need it in this situation anymore. “
To treat or not to treat? Until a person understands that he has a real illness, he will not go to the surgeon. “What for? It doesn’t hurt me! I’m fine, I feel great. To the surgeon? No way!” From strength – to a general practitioner, he will prescribe a drink thinning drugs with a choleretic effect. A person wakes up when problems begin. The incidence of symptoms in patients is up to 50%, the incidence of complications in those who have been identified is 20%. Lethality I have already said.
Tell me, are there such well-known choleretic drugs: squeeze a lemon into a soda and pop a glass, or some drinkers put a tubage on the liver.
This is as part of the procedure. They make both warm and lemon juice with mineral water on an empty stomach, and so on.
For those who have pebbles, what would you advise?
This is horror, horror.First, it hurts terribly. What happens at this moment? Powerful choleretic agents enter an empty stomach. The gallbladder contracts to the maximum, he urgently needs to throw out bile. At this moment, all the calculi that were there begin to push through the biliary tract. The bile ducts are very delicate, their mucous membranes are instantly injured, pain instantly appears, and not everyone who experiences it, who tries it on themselves, safely finishes the procedure at home. Most often, an ambulance call follows.
That is, my friends, I am now addressing the listeners and viewers: if you don’t know what’s going on in your gallbladder, you don’t know for sure, then I don’t recommend you 2 glasses of lemon with soda on an empty stomach. Here, no need!
No way! When people say, “I’m going to do tyubage,” I try to explain why it is not necessary to do it. But, a person is an unpredictable creature, you explain to him, and he insists: I decided, I trust the palmist who is to me … Put in front of you the business card of your surgeon, who will receive you.
It is also desirable to be on duty at night
At night, on weekends, and so on. Put the phone in front of you and experiment on your health. As a last resort, hammer 03 into the phone and start.
Maxim Vyacheslavovich, I wanted to say a few words in defense of planned operations for gallstones. I understand correctly that there are situations when surgeons today have to perform emergency operations, despite the increasing number of planned interventions.But, an operation in an acute situation requires more qualifications of the surgeon and, in principle, they are more difficult. Is it so?
Quite right. Let me explain to you, Anastasia. Planned cholecestectomy is a routine operation that is performed, in general, in every surgical clinic, at least in Moscow, in all clinics. A standard, practiced operation, which is performed, on average, depending on the skill of the surgeon, from 20 to 40 minutes, sometimes 50, hour.It goes on calmly, the person gets up on the day of the operation and begins to serve himself, the next day he already asks to go home. We, depending on the situation, either release him, or watch for another day.
Plus, the patient meets the surgeon in advance, he has time …
… discuss all questions.
Tell me, are some other problems of the body pushing for the planned removal of the gallbladder? It is necessary to change something else in the body, so the gallbladder is removed?
No, the very presence of calculi, the appearance of the clinic is an indication for a planned operation.We explain to the patient: yes, this gallbladder must be removed.
I have come across such a case, maybe you will comment on it. An acquaintance of mine suffered from spinal hernias and flew to Germany to some well-known clinic. There, before doing hernia surgery, it turned out that he had a full gallbladder of stones. He was told: it is imperative to first remove, and then deal with hernias of the spine. It cost him dearly, you know.Was it put up for money, or was it necessary?
No, you need to. To be honest, I have not been closely involved in the surgery of hernia of the spine, but I will give a slightly different situation. A young woman is about to get pregnant, about to give birth. When checking, they find a pile of stones in the gallbladder. We present indications and strongly suggest prophylactic removal of the gallbladder. Yes, maybe he has not been ill with her yet, but to meet with a pregnant woman who has an exacerbation of calculous cholecystitis or what I was talking about, obstructive jaundice, God forbid, God forbid any surgeon! She needs X-rays, complex MRIs, CT scans, and so on.I’m not even talking about the operation, which can complicate the course of pregnancy, and generally cause fetal death or early childbirth.
Let’s go back to the emergency operation.
Emergency operations are, of course, more difficult for us. They last longer, they potentially carry a greater risk of complications, bleeding, and so on.
Including, the transition to open, when the old-fashioned incision on the half of the abdomen.
The transition to open, when we cannot differentiate the elements, when it becomes unsafe to perform a laparoscopic operation, of course. 99% of operations for gallstone disease are now performed laparoscopically.
Small puncture. Nobody is being cut anymore.
Or one, sometimes access through the navel, through one access?
Yes, some clinics use such operations.It seems to me that they did not go into mass surgery, operations through one puncture, because there are certain inconveniences, so to speak. These are nuances. In general, it is performed after 4 punctures, quickly, accurately.
Then the gallbladder is removed through one of the punctures?
Yes. When patients ask: “How are you going to pull out such stones, 2-3 centimeters through a centimeter puncture?”, I say: “Let this remain our secret.We will give them to you, but how we get them out – let it be a little secret. ” It is possible.
That is, there may be indications for a planned operation associated with completely different circumstances, diseases.
Maybe. But, more often than not, the disease is itself. One attack, two attacks. A person comes to consult. We collect all the data about him, about his health, about his ability to undergo surgery, and prepare for a planned operation.
Tell me, after all, not only fat, but overeating, when you ate a lot, as sometimes happens in life, put on a full belly – can it also provoke?
No. Once, I will please everyone: once – no. I said that bile is needed to digest fat. From this we can conclude: women who struggle with themselves through diets, limit the intake of fatty foods in principle, also provoke the appearance of gallstones, because there is no fat – the gallbladder does not need to be constantly emptied, bile does not go out into the intestinal lumen and begins to stagnate.
So that’s why sometimes young thin, slender women get stones!
It is clear, bile does not go, because it has nothing to do. It remains in the gallbladder, where the swamp begins.
But, is it more pleasant for you to deal with young, beautiful, Maxim Vyacheslavovich?
Of course, of course! But, nevertheless, here I am projecting the gaze of the surgeon.If gallstone disease has appeared, settled in the body, you need, at least, to communicate with the surgeon, at least consult, at least keep in touch. You never know what. When manifested, prepare for elective surgery. This is a normal, routine operation that will improve your quality of life.
I will ask an important question, which I think is for everyone who is familiar with the problem of stone disease in the gallbladder. It’s hard to find an answer to it, maybe you can tell.It happens that a stone is found in the gallbladder, and it has reached a certain size there, a centimeter or 0.8. He is checked after 3 years, 5 years, and he is still the same. Why isn’t it growing? Or why is it growing? How to prevent it from growing?
Difficult question. Unfortunately, I don’t have a ready-made answer. Most often it grows. Will explain. We did the first ultrasound examination – he turned sideways to us, we took his size and fixed it: 0.8. Then, after 2 years, he turned the other side, and we saw a smaller size, but he was elongated, and we measured a different size in the cross section.Most often, if the patient was not treated, he did not take drugs that dissolve stones …
If he has a calcified pebble, you won’t dissolve it. Maybe he’s just not growing that fast?
May not grow quickly. No, there are people who walk with gallstones. I said: stones become symptomatic in 50% of patients, the rest, I repeat, will walk with them and die from a completely different – heart attack, stroke, and so on, another sore, with their own gallstones.But, there is one caveat: the person is getting older. When he comes to the category of elderly patients, gains concomitant diseases, then this problem is no longer so easy to cope with.
I understand what you are talking about: it is difficult to treat two diseases at the same time.
And three is even more difficult. Patients who are 80 years old, 90 years old, go to the hospital with a clinic of exacerbation of gallstone disease or acute cholecystitis, and we can no longer offer them an operation so easily.You have to go to other tricks, put tubes in the gallbladder, pierce, and so on. This does not completely solve the problem.
Maksim Vyacheslavovich, everything is clear, you told us very interesting today. Thank you so much! I think that the patients who were interested in the topic learned and heard a lot today. Thank you very much again for taking the time. The story was very interesting.
As a simple patient, I will tell you: you have greatly inspired and comforted us.
Thank you very much!
We in your face have ceased to be afraid of surgeons. This is also important, by the way.
We are trying. We try to arrange, calm down, we are not as aggressive as the jokes tell about us. But when it is necessary – then it is necessary. Inozemtsev City Clinical Hospital, welcome! Please, all information is on our website.
Thank you, friends, thank you for being with us today!
Oleg Druzhbinsky and Anastasia Udilova were with you.Be healthy!
All the best!