Dr Bryan Soder:Gastrointestinal Surgery Holy Family Hospital Bandra

Dr Bryan Soder:Gastrointestinal Surgery Holy Family Hospital Bandra


I’m Dr.Bryan Soder a Gastrointestinal Surgeon with Holy Family Hospital since 1986 I am going to talk about the gallblader and gallstones in particular the gallblader is a pear-shaped cystic organ situated in the right upper abdomen just below the liver gallstones are the commonest cause of upper abdominal pain gallstones are of different type there are cholestrol stones bcoz of high cholestrol there are pigment stones because of rapid breakdown of red blood cells and there are stones caused because of infection Infact the gallstone has been called the tombstone of the bacteria lying within it The gallblader is a vestigial organ by which i mean it can be dispensed with without any ill effects to the patient like the appendix hence incase of any problem with the gall bladder the deceased gallbladder is usually removed The operation is called colostomy gallstones requre to be treated as soon as they become symptomatic except in diabetic patients where even asymptomatic stones would require to be treated because of the very high incidence of empyema of the gallbladder gallstones can present as biliary colic which is a intimiting sharp pain which occurs in the upper abdomen in the center and radiates to the back or as an infection wherein the gallbladder is inflammed and presents with fever dialating pain and gallstones could also move down into the bile duck and cause obsructive jaundice or cause pancreatitis which is a life threatening severe inflammation By convention the gallbladder used to be removed by an a cut in the abdomen about 5 to 6 inches in length however with the advance of technology the gallbladder can now be removed by laparoscopy wherein there would be 3 to 4 punctures of 5 and 10 millimeters the use of a video camera with video enhanced images the whole gallbladder could be dissected and removed through these punctures usually before starting laproscopic surgery we require to create a pneumo peritoneum by which we put a gas commonly carbondioxide is used because carbondioxide is very soluble and gets absorbed 200 times faster than air also it causes less post operative pain in few patients who are high risk for surgery and anesthesia it was better to remove the gallbladder by the open technique however almost 90% of patients would get the gallbladder removed by laproscopic surgery thank you

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