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CHOLECYSTITIS – GALLBLADDER INFLAMMATION

UNDERSTANDING THE PROBLEM

The gallbladder is a small, pear-shaped organ on the right side of the abdomen, just beneath the liver. The gallbladder holds a digestive fluid called bile that's released into the small intestine.
Cholecystitis is inflammation of the gallbladder. The gallbladder is a small, pear-shaped organ on the right side of the abdomen, beneath the liver. The gallbladder holds a digestive fluid that's released into the small intestine (bile).
In most cases, gallstones blocking the tube leading out of the gallbladder cause cholecystitis. This results in a bile buildup that can cause inflammation. Other causes of cholecystitis include bile duct problems and tumors.

Cholecystitis is classified as acute or chronic: Acute cholecystitis begins suddenly, resulting in severe, steady pain in the upper abdomen. The pain usually lasts more than 6 hours. At least 95% of people with acute cholecystitis have gallstones. The inflammation almost always begins without infection, although infection may follow later. Inflammation may cause the gallbladder to fill with fluid and its walls to thicken.
Rarely, a form of acute cholecystitis without gallstones (acalculous cholecystitis) occurs. However, the gallbladder may contain sludge (microscopic particles of materials similar to those in gallstones). Acalculous cholecystitis is more serious than other types of cholecystitis. It tends to occur after the following:

  • Major surgery
  • Critical illnesses such as serious injuries, major burns, or a bloodstream infection (sepsis)
  • Intravenous feedings for a long time
  • Fasting for a long time
  • A deficiency in the immune system

Acute acalculous cholecystitis can occur in young children, perhaps developing from a viral or another infection.

Chronic cholecystitis is gallbladder inflammation that has lasted a long time. It almost always results from gallstones and from prior attacks of acute cholecystitis. Chronic cholecystitis is characterized by repeated attacks of pain (biliary colic) that occur when gallstones periodically block the cystic duct. In chronic cholecystitis, the gallbladder is damaged by repeated attacks of acute inflammation, usually due to gallstones, and may become thick-walled, scarred, and small. The gallstones may block the opening of the gallbladder into the cystic duct or block the cystic duct itself. The gallbladder usually also contains sludge. If scarring is extensive, calcium may be deposited in the walls of the gallbladder, causing them to harden (called porcelain gallbladder).

UNDERSTANDING WHO SUFFERS

More than 20 million Americans are estimated to have gallstones, with 500,000 cholecystectomies performed annually. Many patients with gallstones do not develop symptoms.

Acute cholecystitis is the most frequent complication of gallstones and occurs in 10% of symptomatic patients. Acute acalculous cholecystitis accounts for 5% to 14% of cases of acute cholecystitis.

The incidence of acute cholecystitis is approximately the same in western Europe as in the US, but worldwide the exact incidence is not known. The distribution and incidence follow that of cholelithiasis(gallstones) because of the close relationship between gallstones and acute cholecystitis.

POTENTIAL SIGNS AND SYMPTOMS

Symptoms of cholecystitis can appear suddenly or develop slowly over a period of years. Signs and symptoms include:

  • Severe abdominal pains that may feel sharp or dull
  • Abdominal cramping and bloating
  • Pain that spreads to your back or below your right shoulder blade
  • Fever, chills, nausea, vomiting
  • Loose, light-colored stools
  • Jaundice, which is when your skin and the whites of your eyes turn yellow
  • itching
  • A typical attack can last two or three days, but symptoms of cholecystitis vary widely from person-to-person.
  • Cholecystitis signs and symptoms often occur after a meal, particularly a large or fatty meal.
EXAMINATIONS USUALLY REQUIRED

In addition to obtaining medical history, doctors may also order the following tests and procedures to diagnose cholecystitis:

  • Blood tests to evaluate how well the liver is functioning and whether it is damaged (liver function tests). However, these tests cannot confirm the diagnosis because results are often normal or only slightly high, unless the bile duct is blocked. Other blood tests are also done. For example, the number (count) of white blood cells is measured. A high white blood cell count suggests inflammation, an abscess, gangrene, or a perforated gallbladder.
  • Imaging tests that show the gallbladder, such as abdominal ultrasound or a computerized tomography (CT) scan, can be used to create pictures of the gallbladder that may reveal signs of cholecystitis.
  • Ultrasonography is the best way to detect gallstones in the gallbladder. Ultrasonography can also detect fluid around the gallbladder or thickening of its wall, which are typical of acute cholecystitis. Often, when the ultrasound probe is moved across the upper abdomen above the gallbladder, people report tenderness.
PROPOSING TREATMENT AND WHY AIMIS

Surgery for Gallbladder and Biliary Tract Disorders

If your doctor recommends surgery for a disorder, you may be a candidate for a minimally invasive approach - da Vinci Surgery.

AIMIS is an expert in Robotic Surgery for Robotic Assisted Cholecystectomy, Choledochotomy, Cholecystostomy and other minimal invasive procedures for the Gallbladder and Biliary Tract involving the best American and International surgeons who are experts in the field including:

  • Cholelithiasis – Gallstones - Cholecystectomy (Gallbladder removal), Hepatico-Jejunostomy, Choledochotomy, Cholecystostomy, Intraoperative Cholangiography, Transduodenal Papillosphincterotomy and Plastic Stent
  • Cholecystitis - Gallbladder Inflammation - Cholecystectomy, Hepatico-Jejunostomy, Choledochotomy, Cholecystostomy, Intraoperative Cholangiography, Transduodenal Papillosphincterotomy and Plastic Stent
  • Gallbladder Problems (Obstruction, Hydrops, Perforation, Fitsula) - Cholecystectomy, Hepatico-Jejunostomy, Choledochotomy, Cholecystostomy, Intraoperative Cholangiography, Transduodenal Papillosphincterotomy and Plastic Stent
  • Bile Duct Problems (Obstruction, Hydrops, Perforation, Fistula) - Cholecystectomy, Hepatico-Jejunostomy, Choledochotomy, Cholecystostomy, Intraoperative Cholangiography, Transduodenal Papillosphincterotomy and Plastic Stent
  • Cholangitis -Inflammation/bacterial infection of the biliary tract - Cholecystectomy, Hepatico-Jejunostomy, Choledochotomy, Cholecystostomy, Intraoperative Cholangiography, Transduodenal Papillosphincterotomy and Plastic Stent

Da Vinci Surgery uses state-of-the-art technology to assist doctors in performing a range of delicate operations for gallbladder and biliary tract and offers several potential benefits over traditional open and laparoscopic surgery, including:

  • Low rate of major complications
  • Low conversion rate to open surgery
  • Virtually scarless surgery
  • High patient satisfaction
  • Minimal pain

To see the procedures we undertake with Robotic Xi Surgery, please click here

GETTING MORE INFORMATION BEFORE MOVING FORWARD
YOU MAY HAVE QUESTIONS LIKE:
  • Can I get more information before I commit to this?
  • Can I get a second opinion from you before I commit to this?
  • How can I find out the cost before I have any obligation?
WHAT AIMIS CAN DO:

AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.

AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.

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AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.

 

FURTHER INFORMATION ON THE PROBLEM:

Treatment for cholecystitis usually involves a hospital stay to stabilize the gallbladder inflammation and possible surgery.
Treatment when hospitalized may include:

  • Fasting, to rest the gallbladder.
  • A special diet, to eliminate fat intake.
  • Medication, for pain management.
  • Antibiotics, if there is an infection.

Symptoms are likely to subside in a day or two. However, because cholecystitis may recur frequently, physicians may recommend gallbladder removal.

If treatment is delayed or not available, cholecystitis can lead to a number of serious complications, such as severe infection within the gallbladder. Some of the gallbladder tissue may even die and decay (become gangrenous). This can lead to blood poisoning (septicaemia), which is very serious and can be life-threatening. Other possible complications include the gallbladder bursting (perforating), or a channel (fistula) forming between the gallbladder and gut as a result of continued inflammation.

FURTHER INFORMATION ON INCREASED RISK GROUPS

Having gallstones is the main risk factor for developing cholecystitis.

Gallstones occur when bile, which is normally fluid, forms stones. Gallstones commonly contain lumps of fatty (cholesterol-like) material that has solidified and hardened. Sometimes bile pigments or calcium deposits form gallstones. Sometimes just a few small stones are formed; sometimes a great many. Occasionally, just one large stone is formed. About 1 in 3 women, and 1 in 6 men, form gallstones at some stage in their life. They become more common with increasing age.

FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED

When acute cholecystitis is difficult to diagnose, cholescintigraphy, another imaging test, is useful. For this test, a radioactive substance (radionuclide) is injected intravenously. A gamma camera detects the radioactivity given off, and a computer is used to produce an image. Thus, movement of the radionuclide from the liver through the biliary tract can be followed. Images of the liver, bile ducts, gallbladder, and upper part of the small intestine are taken. If the radionuclide does not fill the gallbladder, the cystic duct is probably blocked by a gallstone. Cholescintigraphy is also useful when doctors suspect acute acalculous cholecystitis.

WHY AIMIS FOR THIS SURGERY

AIMIS is an expert in Robotic Surgery for Robotic Assisted Cholecystectomy, Choledochotomy, Cholecystostomy and other minimal invasive procedures for the Gallbladder and Biliary Tract involving the best American and International surgeons who are experts in the field In contrast to other gallbladder-preserving minimally invasive or interventional methods, robotic is a one-session procedure avoiding the need for post-operative drainage of the gallbladder by a balloon catheter. Robotic cholecystectomy does not cause functional disturbances or severe bile duct injury, as is observed after cholecystectomy.

Da Vinci Surgery uses state-of-the-art technology to assist doctors in performing a range of delicate operations for gallbladder and biliary tract and offers several potential benefits over traditional open and laparoscopic surgery, including:

  • Low rate of major complications
  • Low conversion rate to open surgery
  • Virtually scarless surgery
  • High patient satisfaction
  • Minimal pain

Cholecystectomy through the belly button can be done using traditional single incision laparoscopy or da Vinci® Single-Site® Surgery. The da Vinci System features a magnified 3D high-definition vision system and flexible Single-Site instruments. These features enable your doctor to operate with enhanced vision and precision.

OTHER SERVICES PROVIDED BY AIMIS

In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.

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