Medications to dissolve gallstone

Previously, medications were used to dissolve gallstones. However, the medications have to be taken for 18 months ($300/month), and gallstones tend to recur. This treatment is suitable only, for pure cholesterol stones. Therefore, this form of treatment is not recommended.

Open cholecystectomy

This is the traditional way of removing the gallbladder through a large abdominal incision. Risks and complications include excessive bleeding or infection.

Traditional gallbladder surgery requires a large incision at the abdomen.

Here, a laparoscope (a telescope in which a camera is attached) is inserted through a tiny incision to give a magnified view of the gallbladder. lnstruments are then inserted through other tiny incisions. After the cystic duct and artery (blood supply to the gallbladder) are identified, tied off with clips and cut, the gallbladder is then detached from the liver bed and removed through an opening in the naval. Following the procedure, the small incisions are closed with a stitch or two. Within a few months , the incisions are hardly visible.

In laparascopic surgery, special instrument can be inserted through small incisions.

The Procedure
1. Carbon dioxide gas is introduced into the body to lift the outer layer of tissue from the internal organs.		3. Clips are used to close off the duct and blood vessel at the base of the gallbladder. These harmless clips will be left inside the body. Cautery (electric current) will then be applied to detach the gallbladder from the liver.
3. A cholangiogram catheter is then inserted to take an x-ray of the bile duct.		4. The contents of the gallbladder will be emptied, it resembles a deflated balloon and can be removed through one of the tiny incisions.

By operating through four tiny openings instead of the traditional 20 cm - long incision, most patients have significantly less postoperative pain. They also heal faster and return to normal activities sooner than patients who have undergone the traditional way of operation. The operation should leave smaller scars compared to the traditional method too.

Since the widespread acceptance of this new procedure, surgeons are applying the laparoscopic technique to a broad range of surgical procedures including appendicectomy, lung and bowel surgery.

Note:
It is important to remember that before undergoing any type of surgery, whether laparoscopic or traditional, you should ask your surgeon about his/her training experience.

Recovering after surgery

After your surgery, you may be required to stay in the hospital for a short period. Follow your doctor's advice and rebuild your strength gradually. You may be asked to breathe deeply and cough to clear your lungs. Walking as soon as possible after surgery helps to keep your blood circulating.

As your digestive system adjusts, you may begin to eat normally. Inform your doctor immediately if you discover any side effects that are not expected, such as:

• Fever (over 38oC) or chills, and jaundice
• An incision that drains for longer than a day
• Increasing pain or redness at an incision site
• Some patients may have loose stools on eating oily food too soon after surgery. You should cut down the amount of oil or fat, the body will slowly adjust to oily food after some time.

Gallbladder surgery is one of the most successful kinds of surgery. Most patients go on to live a healthy and normal lifestyle even without their gallbladder.

Ask-a-Nurse Internet Service
Changi General Hospital has an Ask-a-Nurse Serviceon our internet website. The aim of this service is to provide our patients with an additional avenue to ask questions about any signs, symptoms, or health related concerns they may have. The service is provided by our team of experienced nurses, in consultation with our medical specialists and paramedical staff. This service is not intended to substitute medical advice or consultation and should not be used for diagnostic or treatment purposes. To use the service, go to our website at www.cgh.com.sg and click "Ask-a-Nurse" to submit your question. You will hear from us within 3 working days.

We thank the following contributors:

Dr Michael Hoe [ Senior Consultant/Chief of Surgery, Department of Surgery ]
Dr Tay Khoon Hean [ Senior Registrar, Department of Surgery ]
Lee Yen Yen [ Assistant Director, Nursing Administration ]
Pang Huey Ling [ Case Manager, Clinical Services ]

Illustrations : Dr Choy Mei Yee

• 25 Breast Cancer Myths



• All About Breast Cancer



• All About Gallbladder Surgery



• Anaesthesia



• Breast Cancer & You



• IPG: Breast Cancer Surgery



• IPG : Colectomies



• IPG : Hemia Repair



• What You Need To Know About Tonsillectomy



• ABC-Epidural Steriod Injection