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04 February 2021

İsmail Sert

General Surgery Specialist

Gallstones Surgery

Gallstones Surgery

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  • What is gallbladder?
  • The gallbladder is a hollow organ where the bile produced by the liver is stored. Bile is an important secretion for the digestion of fatty food. When a fatty meal is eaten, the gallbladder contracts with the stimulation of a hormone called cholecystokinin, which is secreted by the digestive system. Then, it provides the passage of the bile stored to the main bile duct through the cystic duct and from there to the first part of the small intestine. 


  • How is gallbladder stone formed?
  • Cholesterol and pigments contained in bile collapse in the gall bladder over time and cause the accumulation of viscous liquid like mud. This accumulation turns into advanced gallstones.


  • What will happen if not treated?
  • If gallstones are not treated, they cause gallbladder inflammation by obstructing the bile duct. It also prevents bile flow and pancreas secretions, by falling into the bile ducts. This can lead to complications such as jaundice, biliary tract inflammation, pancreatitis (pancreatic inflammation). However, in most of the patients, the disease shows symptoms before these complications occur and can be early intervened.


  • What are the symptoms of gallstones?
  • Usually, newly formed bile sludge and gallstones do not show symptoms. In fact, academic studies show that about half of all gallstones cause no symptoms in a patient's lifetime. However, when the disease manifests itself, the symptoms are very typical. We can define the pain that is very typical of the biliary system and is called "bilious colic " as follows:
  • - Usually begin suddenly after a meal.
  • - It starts in the upper middle and right part of the abdomen, sometimes hitting the back.
  • - Severe pain in 15-20 minutes, then may continue for up to five hours.
  • - It does not pass with antacid drugs that prevent heartburn, defecation, passing gas, changing position.
  • - It causes excessive sweating, nausea and vomiting.
  • - It causes a stinging sensation on the back while breathing.
  • - It passes over time.


  • How is gallstones diagnosed?
  • The physician performs a physical examination after listening to the patient's complaints and medical history. In addition to ultrasonography of some blood tests, radiological examinations such as computed tomography and MR imaging can be used for definitive diagnosis.


  • How it is treated?
  • The main method of treatment is surgical removal of the gallbladder. The timing of the surgery varies according to the symptoms caused by the stone and the general condition of the patient.


  • How is gallbladder surgery performed?
  • The most common method in gallstone surgery is cholecystectomy. With this method, gallstones and mud, gall bladder inflammation (cholecystitis), large gallbladder polyps and pancreatitis (pancreatitis) can be treated.
  • Indoor and outdoor cholecystectomy method is upset and it is carried out in two methods. Open surgical method which is rarely performed under harsh conditions. Laparoscopic (closed) cholecystectomy surgery which is the most common method. Classical laparoscopic cholecystectomy surgery, where large incisions are not made, is performed through three or four holes opened 1 cm wide in the abdomen. Surgery is performed with the help of a trocar and camera inserted through the holes.
  • The most advanced application of the laparoscopic method is configured with a single port. This method is performed only with a 2 cm incision made through the naval. The advantage of this method is that there is almost no surgical scar left. Gall bladder surgeries are performed by single port cholecystectomy method in our hospital.


  • What awaits me after the operation?
  • After gallbladder surgery, if there is no complication or unusual situation, the patient is discharged on the same day or the next day. Patients can quickly return to their daily life, owing to the laparoscopic surgery, patients may quickly return to their normal and daily life.


  • To what should I pay attention in postoperative nutrition?
  • After gallbladder surgery, you need to follow a diet program that will make your digestive system to work more easily. You should avoid for a while, foods that are difficult to digest such as fatty and processed foods. You can start eating these foods slowly a few months after surgery.


  • There are two surgical treatment approaches in the treatment of gall bladder inflammation: The first approach is called cooling therapy. In this approach, antibiotic treatment is first applied to the patient for 6-8 weeks to reduce inflammation. Then, laparoscopic gallbladder surgery is performed. This method is preferred in many centers.
  • The other method is to perform the surgery in the early period of gall bladder inflammation (in the first week) by laparoscopic method. The advantages of this approach are:
  • - Quick Pain is relieve.
  • - The patient does not have to use antibiotics for a long time. 
  • - During the waiting period, the patient does not need to come to the hospital due to his constant complaints.
  • - Reduction in labor force loss.
  • - During the waiting period, gallstones are prevented from falling into the bile duct and causing new clinical conditions such as bile duct inflammation or pancreatitis.
  • The method adopted in our hospital is early surgery.


  • Use of the checklist
  • Although it is among the most frequently performed operations in the world, the risk of injury to the bile ducts in closed gall bladder surgeries is still at the level of 0.3%. Depending on the person, structural differences are seen in the bile ducts as one of the most important reasons for this. In our General Surgery Department, as in all other surgeries, routine checklists are used to minimize the risk in closed gallbladder surgeries. Because of the checklist, all necessary measures are taken for the health and quality of life of our patients. Our General Surgery Department also accepts patients with bile duct injury and performs completely the necessary treatment.



Assoc. Prof. Dr. İsmail SERT

General Surgery