There are several methods of surgically removing gallstones. Cholecystectomy entails the removal of the gallbladder and the cystic duct. This is often the standard procedure when the problem includes a diseased gallbladder in addition to the gallstone issue.
When the gallbladder is healthy but gallstones are present, patients have other options.
These procedures will get rid of the stones, not the gallbladder. Two of the most common gallstone removal surgery procedures are endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic biliary sphincterotomy (EBS).
What are these procedures?
These methods often occur together. ECRP involves the use of an endoscope to look inside the patient’s body. It also uses a technique called fluoroscopy and X-ray imaging. ECRP is performed to diagnose and treat various health conditions of the bile and pancreatic ducts.
EBS, on the other hand, involves making incisions on the biliary sphincter to remove gallstones lodged in the bile ducts.
Things you need to know before going through surgery for
Doctors often forget to tell you these pieces of information. That’s a little bit curious since these things are crucial in making decisions about gallstone operation. So let’s dig up some facts here:
- The result of a published study shows that ECRP resulted in complications. These include bleeding and pancreatitis in almost 10% of the patients.
- A study was conducted on 2347 patients who underwent EBS. It was found out that about 10% developed complications. More than 50% of these complications resulted in pancreatitis. About 20% resulted in hemorrhage and the rest in direct or indirect deaths.
- Laparoscopic cholecystectomy is less invasive than open cholecystectomy. All the same, it needs meticulous skill on the part of the surgeon. It involves smaller incisions and shorter recovery time. Because of this nature, it has become the standard treatment even when it’s not necessary. Patients think that they need gallstone surgery to treat the problem once and for all.
The blunt truth about gallstone removal is that surgery is not needed in many cases.
It does not stop stones from forming again in the future. There were also findings that laparoscopic gallstone operation has a higher risk of causing bile duct injuries than its open-type version.
- Cholecystectomy, whether open or laparoscopic, has its share of complications. Problems can range from anesthesia to blood clots. Aside from these complications, a patient may also suffer from the post-cholecystectomy syndrome or PCS.
Gallstones could be left in the bile duct, which is not included in the surgery. These gallstones will cause the same pre-op issues.
- Doctors will say that the gallbladder can be removed without consequence to your health. That’s not true. Once your gallbladder has been removed, you will not have a place to concentrate the bile anymore. Whenever you eat a big fatty meal, your body will not be able to digest efficiently like before. That should be easy, you say, just be careful with what you eat.
Your digestive system may now have a hard time absorbing essential fatty acids and fat-soluble nutrients.
And you may want to know this. Most antioxidants and essential nutrients are fat-soluble. You will live, yes, but it will not be the same.
- There are non-surgical alternatives. When the bile contains more cholesterol than bile acids, that’s when cholesterol gallstones form. An oral dissolution therapy or ODT will be very beneficial in this case.
ODT will aid in dissolving cholesterol gallstones, especially stones that are still small in size.
Ursodeoxycholic acid and Chenodeoxycholic acid are most commonly used for this method.
- There’s another non-surgical option called lithotripsy. It uses shock waves to break gallstones into smaller fragments. When broken, they become easier to pass. It is often performed in conjunction with ODT.
This is not to say that you shouldn’t undergo a gallbladder or gallstone surgery. What we say is that not all gallstone cases require an operation. Many people have lived with their silent gallstones for years. They are careful with their diet and lifestyle, and they’re so much healthier for it.