An in-depth report on the causes, diagnosis, treatment, and prevention of gallstones.
Cholecystitis; Choledocholithiasis; Bile duct stones
Percutaneous Cholecystostomy. Percutaneous cholecystostomy is a procedure that may be used in seriously ill patients with severe gallbladder infection who cannot tolerate immediate surgery. It is also the standard treatment for patients with acalculous cholecystitis (gallbladder inflammation without stones). This procedure uses a needle to withdraw fluid from (aspirate) the gallbladder. A drainage catheter is inserted through the skin and into the gallbladder while the fluid drains out. In some cases, the catheter may be left in place for up to 8 weeks. After that time, if possible, laparoscopy or an open cholecystectomy may be performed. Without a laparoscopy, recurrence rates with this procedure are high.
Gallbladder Aspiration. With this procedure, fluid is removed while the gallbladder is viewed using ultrasound. It does not require leaving a catheter in the abdomen afterward, and may have fewer complications than percutaneous cholecystostomy.
Mini-Laparotomy Cholecystostomy. Mini-laparotomy cholecystostomy uses small abdominal incisions but, unlike laparoscopy, it is an "open" procedure, and the surgeon does not operate through a scope. The surgical instruments used are very small (2 - 3 mm in diameter, or about a tenth of an inch). Eventually, this technique may reduce operative time and enable surgeons to obtain better results than with laparoscopy.
Natural Orifice Translumenal Endoscopic Surgery (NOTES). A new procedure may enable surgeons to remove the gallbladder with less pain and a faster recovery time than conventional laparoscopic surgery. In the NOTES procedure, doctors pass an endoscope through a natural opening in the body (such as the vagina in the case of the gallbladder), and then through an internal incision in the stomach, vagina, bladder, or colon. There are no external incisions. This procedure is still considered investigational.
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