doss india - gall stones, gall bladder surgery treatment in pune, maharashtra

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Post on 06-Apr-2016




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Dr. Satish Pattanshetti and Dr. Neeraj V Rayate is best Gall Bladder Surgeon, Gall Stone, Diabetes & Obesity surgeon in pune



  • Anatomy of gallbladder and extrahepatic biliary treeBile Helps the body digest fatsMade in the liverStored in the gallbladder until the body needs itContains: WaterCholesterolBile pigmentsPhospholipidsBicarbonateAnions of the bile acidsConcentrations vary - different kinds of stones may be

  • What are gallstones?Small, pebble-like substancesMultiple or solitaryMay occur anywhere within the biliary tree Have different appearance - depending on their contents

  • Pigment stonesSmallFriableIrregularDark Made of bilirubin and calcium saltsLess than 20% of cholesterolRisk factors:HaemolysisLiver cirrhosisBiliary tract infectionsIleal

  • Cholesterol stonesLargeOften solitaryYellow, white or green Made primarily of cholesterol (>70%)Risk factors:4 F : FemaleFortyFertileFatFair (5th F - more prevalent in Caucasians)Family history (6th F)

  • Mixed stonesMultipleFacetedConsist of:Calcium saltsPigmentCholesterol (30% - 70%)80% - associated with chronic

  • Complications of gallstonesIn the GB:Biliary colicAcute and chronic cholecystitisEmpyemaMucocoeleCarcinomaIn the bile ducts:Obstructive jaundicePancreatitisCholangitisIn the gut:Gallstone

  • SymptomsPain in the RUQMost common and typical symptomMay last for a few minutes to several hoursMostly felt after eating a heavy and high-fat mealPain under right shoulder when lifting up armsFever, nausea and vomiting Jaundice (obstruction of the bile duct passage)Acute pancreatitis (gallstone enters the duct leading to pancreas and blocks it)

  • DiagnosisUltrasoundMost sensitive and specific test for gallstones

    Computerized tomography (CT) scan May show gallstones or complications, such as infection and rupture of GB or bile ducts

    Endoscopic retrograde cholangiopancreatography (ERCP) Used to locate and remove stones in bile ducts Blood testsPerformed to look for signs of infection, obstruction, pancreatitis, or jaundiceCholescintigraphy (HIDA scan) Used to diagnose abnormal contraction of gallbladder or obstruction of bile

  • TreatmentSurgery: Cholecystectomy (gallbladder removal) 5 - 40% of patients develop postcholecystectomy syndrome (gastrointestinal distress and persistent pain in the RUQ)20% of patients develop chronic diarrheaTwo surgical optionsOpen cholecystectomyLaparoscopic

  • Nonsurgical treatment:Only in special situations When a patient has a serious medical condition preventing surgery Only for cholesterol stones

    Oral dissolution therapyUrsodeoxycholic acid - to dissolve cholesterol gallstonesMonths or years of treatment may be necessary before all stones dissolve

    Contact dissolution therapy Eexperimental procedureIinvolves injecting a drug directly into the gallbladder to dissolve cholesterol

  • Contact UsDr. Satish PattanshettiM.S ( Gen. Surg ) , F M A SFellowship in Bariatric and Metabolic Surgery (Taiwan)Consulting Laparoscopic & General SurgeonBariatric & Metabolic SurgeonSpecialist in Single port Laparoscopic SurgeryDr. Neeraj V RayateDirector and Principal SurgeonDr Neeraj Rayate is a GI and General surgeon with expertise is laparoscopic and robotic surgery for gastro-intestinal diseases and bariatric surgery. After completing his medical education in India. He has also completed a fellowship in Gynecological Endoscopy from the Giessen School of Endoscopic Surgery in Germany. Dr. Rayate has special interest in Hepatopancreatobiliary surgery and gynecolological