As a rule, gallbladder complaints are easily treatable. As the digestive organ is not a vital internal organ, you can lead a completely normal life without a gallbladder. Biliary surgery is a branch of visceral surgery, i.e. the surgical treatment of all organs of the digestive tract. Biliary surgery is dedicated to the surgical treatment of the bile. Here you will find further information as well as selected biliary surgeons and biliary centers.
Specialists in biliary surgery are specialists in the field of visceral surgery. Visceral surgeons perform surgical procedures on the abdominal organs. Biliary surgeons have particular experience in treating the gallbladder.
In the vast majority of cases, gallbladder operations are minimally invasive procedures that can be performed using very small incisions. For some types of gallbladder complaints, the doctor may decide to remove the gallbladder completely. After the operation, the patient is usually symptom-free.
The gallbladder measures around eight centimetres and sits as an elongated sac just below the liver. It serves as a temporary reservoir for the bile produced by the liver. Very fine bile ducts collect the bile and channel it into the intestine via the common bile duct. There, the substances contained in the fluid break down the dietary fats.
The location of the gallbladder below the liver © magicmine | AdobeStock
The most common gallbladder disease is cholecystitis. If the bile duct or the gallbladder outlet is blocked, bile accumulates in the gallbladder. This can cause inflammatory reactions.
The cause of bile stasis is usually a gallstone that has entered the bile ducts and is blocking them. Around 25 percent of people who have gallstones experience this at least once in their lives. If there are no gallstones, the risk of gallbladder inflammation is very low. As a rule, it only occurs after an accident or if severe infections are present.
In addition to gallbladder inflammation, there are other diseases of the gallbladder and the hepatobiliary system that require medical treatment. The latter refers to the functional unit consisting of the liver with liver surgery, bile ducts and gallbladder.
Gallstones are often to blame for severe pain in the upper abdomen. If you feel such pain, you should definitely consult a doctor. Gallstones that cause pain can lead to further complications and illnesses.
If they are not treated, they can develop unchecked into
develop unchecked.
Doctors differentiate between
Gallstones can also be harmless. Many people with gallstones have no symptoms for years or their entire lives.
Only when an obstruction occurs does it become painful. This results in biliary colic and the associated pain in the right upper abdomen. With biliary colic, the pain comes and goes in waves. Biliary colic can last for hours.
Those affected also often suffer from severe fever, accompanied by
If the bile backs up into the liver, the eyes and skin may turn yellow(icterus).
On the left is a healthy gallbladder, on the right it contains gallstones © Henrie | AdobeStock
Biliary diseases are diagnosed and treated by specialists with expert knowledge in biliary surgery. The doctor determines the diagnostic procedure depending on the location of the stones. Palpation and ultrasound are usually sufficient to diagnose a biliary disorder with certainty. In some cases, however, a cystoscopy is necessary.
On this basis, the gallbladder expert will determine a suitable form of treatment.
Ultrasound examination is the method of choice for diagnosing biliary colic.
Both diagnosis and treatment are carried out using endoscopic retrograde cholangiopancreatography(ERCP). The doctor inserts a thin tube with a small camera through the neck into the duodenum, where the bile duct system opens. With the help of an injected contrast agent, pathological changes such as the obstruction of a gallstone can be clearly seen on the X-ray image.
If the colic is caused by smaller gallstones, they can sometimes be treated with medication. If this is not sufficient, the gallstones or the entire gallbladder must be removed. Medical devices are inserted via the endoscope (ERCP).
This minimally invasive form of treatment is known as laparoscopic surgery, also known as keyhole surgery. Large abdominal incisions are rarely necessary to remove the gallbladder.
With the help of a stent or tube, bile strictures can also be widened in this way.
Chronic bile outflow obstruction causes similar symptoms to colic, although usually in a milder form.
It is characterized by uncharacteristic symptoms such as
This is caused by inflammatory changes in the bile ducts.
A specialist will diagnose the drainage disorder based on elevated blood levels of the yellow blood pigment bilirubin. In addition to the blood count, sonography is also used to diagnose a bile drainage disorder.
The choice of treatment depends on the cause of the biliary disorder. If the disorder is caused by gallstones, the forms of treatment already mentioned are used. However, if the pain is caused by a tumor of the bile ducts or gallbladder, more extensive treatment is required.
Biliary tract and gallbladder tumors occur less frequently than gallstones and gallbladder inflammation. Symptoms only appear in the later stages of cancer, meaning that the disease is usually already well advanced at the time of diagnosis.
It can be recognized, for example, by a backlog of bile in the liver and the associated yellowing of the skin and eyes. It can also lead to
can occur.
The eyes take on a yellow color in bile stasis © blackday | AdobeStock
Endoscopic imaging using injected contrast media (ERCP) plays an important role in diagnostic aids. Other diagnostic procedures are
At an early stage of development, it is usually still possible to stop the spread of the tumor. To do this, the gallbladder or bile ducts must be removed at an early stage. Sometimes it is also necessary to remove part of the liver.
If the tumor growth is already so advanced, a cure is no longer possible. In this case, therapy is only concerned with alleviating the symptoms and prolonging the patient's life.
Relieving congested bile ducts by means of endoscopic drainage and stent implantation plays an important role here. Chemotherapy is also an option for patients in good general health.
As a patient, where can you find specialists in biliary surgery or gastroenterology?
It is not possible to name a single clinic or specialist as the best place to go if you have a gallbladder problem. However, there are clinics as well as specialized centers and doctors in private practice who specialize in the surgical treatment of biliary diseases and have a lot of experience in this field.
When treating tumors, always ensure close consultation between gallbladder specialists, gastroenterologists, oncologists and radiologists.
Cramp-like pain in the upper abdomen that even radiates to the back or shoulders - biliary complaints and their effects are not only unpleasant and stressful, but can also be dangerous.
The form of treatment depends on the symptoms: gallstones can be easily removed, but they can also be life-threatening carcinomas. In any case, you should consult a specialist if you experience pain or other symptoms.
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