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Gall bladder stone

  • Gall bladder stone
    • Can we treat gallstones effectively 100% by medical drugs?
      • Medical therapy is possible for dissolving gallstones. But is it complicated. There are number of conditions that need to be satisfied.
      • There should be multiple gallstones of <5–7mm size
      • Good functioning of gall bladder as assessed by a separate test
      • Patency of duct from gall bladder has to be confirmed
      • No complications from gall stone should be present
      • Gallstones should be cholesterol  type.
      • This therapy has only modest efficiency when above conditions are met and there is 100% recurrence on stopping medicines.
      • Due to the above reasons, medical treatment of gallstones have not become popular and unused.
      • Whenever required to remove gallstones, the most efficient method is to do a cholecystectomy (i.e. removal of the gall bladder).
      • This is a very simple surgery with <1% rates of complications if done by expert surgeons.
      • Gallstones are highly prevalent inn adults with one study putting it at 6% in the general population.
      • Only 10% of gallstones require treatment when they develop symptoms.
      • To summarise
      • Only a fraction of patients with gallstones require treatment
      • Medical therapy is successful in certain patients
      • 100% recurrence on stopping treatment
      • Surgery is simple and effective
    • I have a gall bladder stone of 17mm. However I have no pain or problem. Should I get my surgery done?
      • The answer is NO based on the information provided.
      • However, consult with a surgeon as under certain conditions surgery maybe required. A discussion of risks vs benefits of surgery and watchful waiting is needed.
      • It you don’t opt for surgery, monitor stone at 3–6 monthly intervals. If size is >20mm, it may be removed.
      • If you are from UP near Ganges belt, better to get it removed as there are high rates of cancer there.
    • What are the changes or complications in digestion after gallbladder removal surgery?
      • The gall bladder does perform a function in the body, which is concentration of the bile secreted from the liver and release it after ingestion of meals. The bile is helpful in the digestion of fats in the diet.
      • This function is affected  due to removal of the gall bladder.
      • But the body manages to compensate for this and digestion is not much affected overall. It is advisable to avoid a diet rich in fats after the surgery. The fats contained in everyday Indian diet can be easily digested.
      • The rates of complications like anaesthesia risk, infection, bleeding and bile duct injury are around 1%, which is quite acceptable.
      • There are upcoming reports of bile reflux increasing after the surgery causing gastritis and esophagitis, but the link is still not proven.
      • The benefits have to be weighed against the risks of performing any surgery. Please consult a surgeon to guide you.

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