How are gallstones diagnosed. What treatment options are available for gallstones. Can gallstones go away on their own. When is surgery necessary for gallstones. What are the risks of leaving gallstones untreated. How effective are non-surgical treatments for gallstones. What lifestyle changes can help prevent gallstones.

Understanding Gallstones: Causes, Symptoms, and Diagnosis

Gallstones are solid, pebble-like deposits that form in the gallbladder. They can vary in size from as small as a grain of sand to as large as a golf ball. Gallstones are primarily composed of cholesterol or bilirubin, a waste product from the breakdown of red blood cells.

Common symptoms of gallstones include:

• Sudden, intense pain in the upper right abdomen
• Pain between the shoulder blades
• Nausea and vomiting
• Fever and chills
• Jaundice (yellowing of the skin and eyes)

Can gallstones be diagnosed through a physical examination alone? While a doctor may suspect gallstones based on symptoms and a physical exam, additional tests are typically required for a definitive diagnosis. These may include:

1. Ultrasound: This is the most common and preferred method for detecting gallstones. It uses high-frequency sound waves to create images of the gallbladder and surrounding organs.
2. Blood tests: These can help identify signs of infection or obstruction in the bile ducts.
3. CT scan: This imaging test provides detailed cross-sectional images of the abdomen and can help identify complications associated with gallstones.
4. ERCP (Endoscopic Retrograde Cholangiopancreatography): This procedure allows doctors to examine the bile ducts and potentially remove stones during the same procedure.

The Natural Course of Gallstones: Do They Dissolve on Their Own?

One of the most common questions patients ask is whether gallstones can disappear without medical intervention. The answer is not straightforward and depends on various factors.

Do gallstones ever dissolve naturally? In some cases, small gallstones may pass through the bile duct and out of the body without causing symptoms. However, this is not common for larger stones or those causing blockages.

Factors that may influence the natural course of gallstones include:

• Size and composition of the stones
• Location within the gallbladder or bile ducts
• Overall health of the patient
• Dietary and lifestyle factors

While spontaneous dissolution of gallstones is possible, it’s not a reliable or predictable outcome. Most gallstones that cause symptoms will require some form of medical intervention.

Watchful Waiting: When Is It Appropriate for Gallstone Management?

In some cases, doctors may recommend a “watchful waiting” approach for managing gallstones. This strategy involves monitoring the condition without immediate intervention.

When might watchful waiting be considered for gallstones? This approach is typically recommended in the following scenarios:

• Asymptomatic gallstones discovered incidentally
• Mild or infrequent symptoms
• Patients with high surgical risks
• Pregnancy (when surgery may pose additional risks)

During the watchful waiting period, patients are advised to:

1. Monitor their symptoms closely
2. Report any changes or worsening of symptoms to their doctor
3. Follow a healthy diet low in saturated fats
4. Maintain a healthy weight
5. Stay hydrated

Is watchful waiting always a safe option for gallstones? While it can be appropriate in certain cases, it’s crucial to remain under medical supervision. Untreated symptomatic gallstones can lead to complications such as inflammation of the gallbladder (cholecystitis), blockage of the bile ducts, or pancreatitis.

Non-Surgical Treatments for Gallstones: Effectiveness and Limitations

For patients who are not candidates for surgery or prefer to avoid it, several non-surgical treatments for gallstones are available. However, it’s important to understand their effectiveness and limitations.

Oral Dissolution Therapy

This treatment involves taking medications that can help dissolve cholesterol-based gallstones over time. The most commonly used drug is ursodeoxycholic acid (Ursodiol).

How effective is oral dissolution therapy for gallstones? While it can be successful in some cases, it has several limitations:

• Only works on cholesterol stones (not pigment stones)
• Most effective for small stones (less than 5mm in diameter)
• Treatment can take months to years
• High recurrence rate after treatment is stopped

Shock Wave Lithotripsy

This procedure uses high-energy shock waves to break gallstones into smaller pieces that can pass more easily through the bile ducts.

What are the success rates of shock wave lithotripsy for gallstones? While it can be effective for some patients, it has limitations:

• Most suitable for single, larger stones
• May require multiple sessions
• Risk of stone recurrence
• Not widely available

ERCP (Endoscopic Retrograde Cholangiopancreatography)

This procedure can be used to remove stones from the bile duct but cannot address stones within the gallbladder itself.

When is ERCP recommended for gallstone treatment? It’s typically used in cases where stones are blocking the bile ducts or when there’s a high suspicion of stones in the common bile duct.

Surgical Removal of the Gallbladder: When Is It Necessary?

Cholecystectomy, or surgical removal of the gallbladder, is the most definitive treatment for gallstones. It’s considered when other treatments have failed or are not suitable.

What are the indications for gallbladder removal surgery? Common reasons include:

• Recurrent episodes of biliary colic (gallstone pain)
• Acute cholecystitis (inflammation of the gallbladder)
• Gallstone pancreatitis
• Large gallstones (over 3cm in diameter)
• Porcelain gallbladder (calcification of the gallbladder wall)

How is gallbladder removal surgery performed? There are two main approaches:

1. Laparoscopic cholecystectomy: This minimally invasive procedure is the most common. It involves making small incisions in the abdomen and using a camera and specialized instruments to remove the gallbladder.
2. Open cholecystectomy: This traditional method involves a larger incision and is typically reserved for complex cases or when laparoscopic surgery is not possible.

What are the risks and benefits of gallbladder removal? While generally considered safe, potential risks include infection, bleeding, and injury to surrounding structures. Benefits include permanent relief from gallstone symptoms and prevention of future gallstone formation.

Life After Gallbladder Removal: Adjustments and Long-Term Outlook

Many patients wonder about the impact of living without a gallbladder. While the gallbladder serves a purpose in storing and concentrating bile, it’s not essential for digestion or overall health.

What changes can patients expect after gallbladder removal? Most people adapt well, but some may experience:

• Temporary diarrhea or loose stools
• Difficulty digesting fatty foods
• Occasional abdominal discomfort

How can patients manage their diet after gallbladder removal? Recommendations include:

1. Gradually reintroducing fats into the diet
2. Eating smaller, more frequent meals
3. Avoiding trigger foods that cause discomfort
4. Increasing fiber intake to help regulate bowel movements

Is it possible to develop gallstones after gallbladder removal? While gallstones cannot form in the gallbladder after its removal, it’s still possible (though rare) for stones to form in the bile ducts.

Preventing Gallstones: Lifestyle Changes and Risk Reduction

While not all gallstones can be prevented, certain lifestyle modifications may help reduce the risk of their formation.

What dietary changes can help prevent gallstones? Consider the following:

• Maintain a healthy weight (avoid rapid weight loss or gain)
• Eat a balanced diet rich in fruits, vegetables, and whole grains
• Limit saturated fats and increase healthy fats (like those found in olive oil and fish)
• Stay hydrated
• Avoid skipping meals

Can exercise help prevent gallstones? Regular physical activity can indeed play a role in gallstone prevention by:

1. Helping maintain a healthy weight
2. Improving cholesterol levels
3. Enhancing overall digestive health

Are there specific populations at higher risk for gallstones? Yes, certain factors increase the likelihood of developing gallstones:

• Being female (especially during pregnancy or while taking hormone replacement therapy)
• Being over 40 years old
• Having a family history of gallstones
• Certain medical conditions (like diabetes or liver disease)
• Rapid weight loss or prolonged fasting

Alternative and Complementary Approaches to Gallstone Management

While conventional medical treatments remain the gold standard for gallstone management, some patients explore alternative or complementary approaches.

What alternative therapies are sometimes used for gallstone management? Some options include:

• Herbal remedies (e.g., milk thistle, peppermint)
• Acupuncture
• Castor oil packs
• Apple cider vinegar

Are these alternative treatments effective for gallstones? It’s important to note that most alternative therapies lack strong scientific evidence supporting their effectiveness for gallstone treatment. Patients should always consult with their healthcare provider before trying any alternative treatments.

Can dietary supplements help with gallstone prevention or management? While some supplements are marketed for gallbladder health, their effectiveness is generally unproven. However, maintaining adequate levels of certain nutrients may be beneficial:

1. Vitamin C (may help break down cholesterol in bile)
2. Omega-3 fatty acids (may help reduce inflammation)
3. Lecithin (may help emulsify fats)

What role does stress management play in gallstone prevention? While stress itself doesn’t directly cause gallstones, it can contribute to unhealthy eating habits and weight gain, which are risk factors. Incorporating stress-reduction techniques like meditation, yoga, or deep breathing exercises may indirectly support gallbladder health.

The Future of Gallstone Treatment: Emerging Technologies and Research

As medical science advances, new approaches to gallstone management are being explored.

What new technologies are being developed for gallstone treatment? Some promising areas of research include:

• Improved dissolution agents: Researchers are working on more effective medications to dissolve gallstones without surgery.
• Nanotechnology: This could potentially allow for targeted drug delivery to break down gallstones more efficiently.
• Advanced imaging techniques: These may allow for earlier detection and more precise treatment of gallstones.
• Minimally invasive procedures: New techniques are being developed to remove gallstones with even less invasive methods than current laparoscopic surgery.

How might genetic research impact gallstone treatment in the future? Understanding the genetic factors that contribute to gallstone formation could lead to:

1. Better prediction of who is at risk for gallstones
2. Personalized prevention strategies
3. Targeted therapies based on an individual’s genetic profile

What role might artificial intelligence play in gallstone management? AI could potentially assist in:

• More accurate diagnosis of gallstones through image analysis
• Predicting which patients are most likely to benefit from specific treatments
• Optimizing surgical planning for complicated cases

As research continues, it’s likely that gallstone treatment will become more personalized, less invasive, and more effective. However, it’s important to remember that current established treatments remain the most reliable options for managing gallstones.

In conclusion, while gallstones can be a painful and potentially serious condition, there are numerous treatment options available. From watchful waiting to surgical intervention, the approach depends on the individual patient’s circumstances. By understanding the causes, symptoms, and treatment options for gallstones, patients can work with their healthcare providers to make informed decisions about their care. Whether through lifestyle modifications, medical management, or surgical intervention, most people with gallstones can find relief and maintain good digestive health.

Gallstones Diagnosis, Tests, & Treatments

Written by WebMD Editorial Contributors

• How Do I Know if I Have Gallstones?
• What Are the Treatments for Gallstones?
• Conventional Medicine for Gallstones
• Gallstones and Watchful Waiting
• Nonsurgical Therapy for Gallstones
• Surgery to Remove the Gallbladder
• More

If your symptoms suggest a gallstone problem, your doctor might first examine your skin for jaundice, and then feel your abdomen to check for tenderness. A blood test may reveal evidence of an obstruction.

Because other digestive problems, such as an infection of the duct, can produce symptoms similar to those of a gallstone attack, the doctor may also run other tests to determine if gallstones are in fact the culprit.

The most common technique is an ultrasound exam. This quick, painless procedure uses high-frequency sound waves to create pictures of the gallbladder, bile duct, and their contents. CT scans are also sometimes done to look at the anatomy of your internal organs.

A more complicated test may be used if the doctor suspects that a gallstone is lodged in a bile duct. Commonly known by the acronym ERCP, this test allows the doctor to look at the bile duct through a small flexible tube called an endoscope. The doctor sprays the back of the patient’s throat with an anesthetic drug to prevent gagging, sedates the patient, and passes the endoscope into the mouth, through the stomach, and into the area of the small intestine where the bile duct enters. Dye is injected through the tube and into the bile duct, and then the doctor takes X-rays. Stone removal can be done during this procedure as well. The procedure takes about an hour.

In most cases, treatment of gallstones is considered necessary only if you are having symptoms. Of the various conventional treatments that are available, surgical removal of the gallbladder is the most widely used. Some alternative treatments have also been found to be effective in alleviating the symptoms of troublesome gallstones.

When deciding what course of action to take for symptomatic gallstones, doctors usually choose from among three main treatment options: Watchful waiting, nonsurgical therapy, and surgical removal of the gallbladder.

Though a gallstone episode can be extremely painful or frightening, almost a third to half of all people who experience an attack never have a recurrence. In some cases, the stone dissolves or becomes dislodged and thereby resumes its “silence.” Because the problem may solve itself without intervention, many doctors take a wait-and-see approach following the initial episode.

Even when the patient has had repeated gallstone episodes, the doctor may postpone treatment or surgery because of other health concerns. If your surgery has been delayed, you should remain under a doctor’s care and report any recurrences of gallstone symptoms immediately.

If you are unable or unwilling to go through surgery for a gallstone problem that requires treatment, your doctor may recommend one of several noninvasive techniques. Note that though these methods may destroy symptom-causing gallstones, they can do nothing to prevent others from forming, and recurrence is common.

Some gallstones can be dissolved through the use of a bile salt, although the procedure can be used only with stones formed from cholesterol and not from bile pigments. The drug Actigall (ursodiol) is taken as a tablet; depending on its size, the gallstone may take months or even years to go away. Because some stones are calcified, this treatment often doesn’t work.

Another nonsurgical technique, shock wave therapy, uses high-frequency sound waves to fragment the stones. Bile salt is administered afterward to dissolve small pieces. This therapy is rarely used.

Doctors can also attempt to remove gallstones during an ERCP. During the procedure an instrument is inserted through the endoscope to attempt removal of the stone.

While these therapies may work for some, all of the above nonsurgical therapies are usually unsuccessful long term (since recurrence is common) and are rarely advised in clinical practice.

While the gallbladder serves an important function, it is not essential for a normal, healthy life. When gallstones are persistently troublesome, doctors often recommend removing the organ entirely. This operation is considered among the safest of all surgical procedures. Each year approximately 750,000 Americans have their gallbladder removed. It is also the only treatment method that eliminates the possibility that other gallstones will develop in the future.

When the gallbladder has been removed, bile flows directly from the liver into the small intestine, and this sometimes leads to diarrhea. Because bile no longer accumulates in the gallbladder, quantities of the digestive fluid cannot be stored up and used to break down an especially fatty meal. This condition is not considered serious, however, and can be corrected by simply limiting fat in the diet.

In the past, removal of the gallbladder was done through traditional “open” surgery, which requires surgeons to make a large incision in the abdomen. Patients faced a two- or three-day hospital stay plus several weeks of recovery at home.

Today, however, the most commonly used surgical technique is a much simpler approach known as laparoscopic cholecystectomy. The doctor makes several small incisions in the abdomen, then uses special pencil-thin instruments to remove the gallbladder. A tiny microscope and video camera, snaked through the incision to the site, allow the surgeon to view the operation.

Laparoscopic surgery is highly effective and very safe. It has reduced the hospital stay to a day or two. Patients report less pain and are generally able to resume a normal lifestyle in a short period of time. However, people who are obese or who have a severe infection or inflammation in the gallbladder may still be considered candidates for traditional open surgery.

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Gallstones Picture, Causes, Age, & Symptoms

Written by WebMD Editorial Contributors

• What Causes Gallstones?

Gallstones are crystal-like deposits that develop in the gallbladder — a small, pear-shaped organ that stores bile, a digestive fluid produced by the liver.

These deposits may be as small as a grain of sand or as large as a golf ball; they may be hard or soft, smooth or jagged. You may have several gallstones or just one.

Some 30 million American adults suffer from gallstones. Yet most of those who have the condition do not realize it. In this case, what you don’t know probably won’t hurt you; gallstones that are simply floating around inside the gallbladder generally cause no symptoms and no harm.

These “silent” stones usually go unnoticed unless they show up in an ultrasound exam conducted for some other reason. However, the longer a stone exists in the gallbladder, the more likely it is to become problematic. People who have gallstones without symptoms have 20% chance of having an episode of pain during their lifetime.

When symptoms do occur, it’s usually because the gallstone has moved and become lodged within a duct that carries bile, such as the cystic duct, a small conduit that connects the gallbladder to another tube called the common bile duct. The typical symptom is abdominal pain, perhaps accompanied by nausea, indigestion, or fever. The pain, caused by the gallbladder’s contraction against the lodged stone, generally occurs within an hour of eating a large meal or in the middle of the night. Stones can also clog the common bile duct, which carries bile into the small intestine, and the hepatic ducts, which take bile out of the liver.

Obstructions in the bile pathway may cause a duct to become inflamed and possibly infected. Blockage of the common bile duct, which merges with the pancreatic duct at the small intestine, can also lead to inflammation of the pancreas (gallstone pancreatitis).

In a rare but dangerous condition that occurs most often in older women, gallstones migrate into the small intestine and block the passageway into the large intestine; symptoms include severe and frequent vomiting. Although gallstones are present in about 80% of people with gallbladder cancer, it is uncertain whether gallstones play a role, except when really large stones (greater than 3 centimeters in diameter) are present.

About a million new cases of gallstones are diagnosed in the U.S. each year. For reasons that are still unclear, women are two times more likely than men to be afflicted. Native Americans have the highest rates of gallstones in the U.S. because they have a genetic disposition to secrete high levels of cholesterol in bile (a contributing factor to gallstones.) Mexican-Americans also have high rates of gallstones.

Gallstones are also more common in people over age 60, in those who are obese or have lost a lot of weight in a short amount of time, in those who have diabetes or sickle cell disease, and in women who have had multiple pregnancies and who take hormone replacement therapy or birth control pills.

The primary function of the gallbladder is to store bile, a brown or yellowish fluid that helps the body break down fatty food. When you eat a meal, the gallbladder releases its stored bile into the cystic duct. From there the fluid passes through the common bile duct and into the small intestine to mix with food.

Chief among the ingredients of bile are cholesterol and bile acids. Normally, the concentration of bile acids is high enough to break down the cholesterol in the mixture and keep it in liquid form. However, a diet high in fat can tip this delicate balance, causing the liver to produce more cholesterol than the bile acids are able to handle. As a result, some of this excess cholesterol begins to solidify into crystals, which we call gallstones. About 80% of all gallstones are called cholesterol stones and are created this way. The remaining 20% consist of calcium mixed with the bile pigment bilirubin and are called pigment stones. Sickle cell and other blood disorders where red blood cells are destroyed can often lead to pigment gallstones

Gallstones can form even in people who eat properly. And as researchers have found, a diet extremely low in fat can also contribute to gallstone formation: With little fatty food to digest, the gallbladder is called into play less frequently than usual, so the cholesterol has more time to solidify. Other factors that can reduce activity in the gallbladder, possibly leading to gallstone formation, include cirrhosis, the use of birth control pills or hormone replacement therapy, and pregnancy.

Family history, diabetes, sudden weight loss, and cholesterol drugs, and older age can also increase risk for gallstones.

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symptoms and when to see a doctor

Gallstone disease (GSD) is the formation of stones (calculi) in the gallbladder and bile ducts. Gallstones are hardened deposits of digestive fluid that most commonly form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just below your liver. The gallbladder contains a digestive fluid called bile, which is secreted into the small intestine to aid in the digestion of food.

Gallbladder stones range in size from a grain of sand to a golf ball. Some people develop only one gallstone, while others develop many small stones at the same time.

The presence of stones carries the risk of developing dangerous conditions and severe complications.

Symptoms

Gallstones often cause no signs or symptoms. If a gallstone gets stuck in the duct and causes a blockage, the following symptoms develop:

• Sudden and rapidly increasing pain in the center of the abdomen, just below the sternum, on the right
• Pain in the back between the shoulder blades
• Right shoulder pain
• Nausea or vomiting
• Pain associated with gallstone disease can last from several minutes to several hours

When to see a doctor

Make an appointment with your doctor if you have any signs or symptoms that worry you.

Read about the diagnosis and treatment of cholelithiasis at the link.

Seek care right away if you develop signs and symptoms of a serious complication associated with gallstones, for example:

• Abdominal pain so severe that you cannot sit still or find a comfortable position
• Yellowing of the skin and whites of the eyes (jaundice)
• High fever with chills

Number for calling an ambulance in Moscow – 103

Causes of cholelithiasis

It is unclear what causes gallstones. Doctors believe that gallstones can occur in the following cases:

Your bile contains too much cholesterol . Normally, your bile contains enough chemicals to dissolve the cholesterol secreted by your liver. But if your liver secretes more cholesterol than bile can dissolve, the excess cholesterol can turn into crystals and eventually stones.

Your bile contains too much bilirubin . Bilirubin is a chemical produced when red blood cells are broken down in the body. Under certain conditions, the liver produces too much bilirubin, including cirrhosis of the liver, biliary tract infections, and certain blood disorders. Excess bilirubin contributes to the formation of gallstones.

Your gallbladder is not emptying properly. If the gallbladder does not empty completely or often enough, the bile can become very concentrated, which promotes the formation of gallstones.

Types of gallstones

Types of gallstones that can form in the gallbladder include:

Cholesterol stones in the gallbladder. The most common type of gallstones, called cholesterol gallstones, are often yellow in color. These gallstones are made up primarily of undissolved cholesterol, but may contain other components.

Pigment stones in the gallbladder. These dark brown or black stones form when your bile contains too much bilirubin.

Risk factors

Factors that may increase the risk of gallstones include:

• Female gender
• Age 40 and over
• Overweight or obese
• Sedentary
• Pregnancy
• High fat diet
• High cholesterol diet
• Low fiber diet
• Family history of gallstones
• Diabetes
• Presence of certain blood disorders such as sickle cell anemia or leukemia
• Very fast weight loss
• Taking medications containing estrogen, such as oral contraceptives or hormone therapy drugs.
• Liver disease

Complications

Complications of gallstones may include:

Inflammation of the gallbladder . A gallstone lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain, peritonitis.

Blockage of the common bile duct . Gallstones can block the channels (ducts) that carry bile from the gallbladder or liver to the small intestine. This can lead to severe pain, jaundice, and bile duct infection.

Obstruction of the pancreatic duct . The pancreatic duct is a tube from the pancreas and joins the common bile duct just before entering the duodenum. The pancreatic juices that aid digestion pass through the pancreatic duct.

A gallstone can cause blockage of the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes severe, persistent abdominal pain and usually requires hospitalization. Severe forms of pancreatitis often end in the death of the patient.

Gall bladder cancer . People with gallstones have an increased risk of developing gallbladder cancer.

Prevention of gallstones

You can reduce the risk of gallstones:

Do not skip meals . Try to stick to your regular meal times every day. Skipping meals or fasting can increase your risk of gallstones.

Lose weight slowly . If you need to lose weight, take your time. Rapid weight loss can increase the risk of gallstones.

Eat more high fiber foods . Include more fiber-rich foods in your diet, such as fruits, vegetables, and whole grains.

Maintain a healthy weight . Obesity and overweight increase the risk of gallstones. Work towards a healthy weight by cutting calories and increasing physical activity. Once you reach a healthy weight, work on maintaining it by continuing to eat a healthy diet and keep exercising.

Treatment and removal of gallstones (treatment of gallstone disease, surgery), gallstones laparoscopy in Nizhny Novgorod at clinic

Gallstone disease is a problem that worries a large part of the population. The main contingent of patients are people with overweight, impaired metabolic processes in the body, diseases of the biliary tract, associated with stagnation of bile in the gallbladder.

The occurrence of stones in the gallbladder is a process associated with the stagnation of bile, the precipitation of cholesterol crystals contained in it. Gradually, small crystals combine and form stones, which sometimes reach impressive sizes. Under the action of the contraction of the bladder, it is possible for the stone to pass through the ducts.

Not always the size of the stone allows it to pass freely, which often leads to obstruction of the duct, accompanied by the so-called hepatic colic – acute paroxysmal pain in the right hypochondrium, and jaundice may also occur.

A large, heavy stone that lies in the gallbladder can form a decubitus due to constant pressure, and subsequently perforate the wall of the gallbladder with the development of peritonitis. All these complications can be prevented if timely treatment of gallstone disease , namely, to remove stones from the gallbladder.

To make a diagnosis, various measures are required (blood tests, ultrasound, x-rays with and without contrast). In particularly difficult cases, it is possible to perform a diagnostic laparoscopy.

Gallbladder stones may not cause any symptoms at all, so it is important to consider this disease in the differential diagnosis.

Gallbladder stones – treatment, modern approach to the problem

Treatment of gallstones can be conservative (without surgery) or surgical. Many people are afraid to go for surgery, as it is associated, in their opinion, with a great risk to health. But they expose themselves to even greater risk by refusing surgery for gallstone disease. Conservative treatment of cholelithiasis is possible in the presence of stones, ideally 5 mm (size up to 15-20 mm is allowed).

We must not forget that getting rid of stones, but not curing the main cause of their occurrence, you can get a relapse of the disease. Therefore, a radical treatment for gallstones is removal of stones from the gallbladder together with it. The operation is called a cholecystectomy.

The classic option for the surgical treatment of gallstone disease is cholecystectomy with laparotomic access (that is, an incision on the anterior abdominal wall).

However, medicine does not stand still and because of its trauma, long recovery period and possible complications, the method fades into the background. The current alternative (and the “gold standard for gallstone surgery”) is laparoscopic cholecystectomy.

The advantage of such an operation for cholelithiasis is that not one large incision is made, but several small ones (5-10 mm in size), which significantly reduces tissue trauma. Trocars and an optical device are inserted into the abdominal cavity through the holes, which transmits the image to the screen.

In this way, the surgeon can examine the gallbladder as well as adjacent organs. Removal of stones from the gallbladder is not performed separately.

During the operation, the entire gallbladder is removed along with its contents using a special electric knife, which ensures a minimum of bleeding. The gallbladder is placed in a special plastic bag in order to remove it from the abdominal cavity without tearing it. This is the prevention of the development of bile peritonitis. Also, the use of such a bag allows at laparoscopy, remove gallstones one by one if they are large and cannot pass through a small hole in the abdominal wall at the same time.

Surgery for cholelithiasis is a guarantee of successful recovery and adequate prevention of relapses.

Advantages of laparoscopic surgery for cholelithiasis:

• Early activation period of the patient
• Minimize trauma and reduce the risk of complications
• Fast and accurate operation

Treatment of stones in the gallbladder in Nizhny Novgorod

Removal of stones from the gallbladder is possible during a laparoscopic operation – cholecystectomy. This manipulation requires clear and coordinated actions on the part of all participants. Treatment of stones in the gallbladder in Nizhny Novgorod (including surgery) is possible in the TONUS PREMIUM MC.