Cholesterol Gallstone Treatment

Diagnosis And Treatment of Cholesterol Gallstone

Diagnosis of Cholesterol Gallstone

The diagnosis of cholesterol gallstones typically involves a combination of medical history, physical examination, and diagnostic tests. A healthcare professional will ask you about your symptoms and the history of health concerns that make you more likely to get cholesterol gallstones. The healthcare professional may also ask if you have a family history of gallstones. 

During a physical exam, the healthcare professional examines your body to check for signs such as tenderness or pain in the abdomen. Diagnostic tests and procedures used to diagnose cholesterol gallstones and complications of cholesterol gallstones include:

• Abdominal ultrasound. This is the most commonly used test to look for signs of cholesterol gallstones. Abdominal ultrasound involves moving a device (transducer) back and forth across the stomach region. The transducer transmits signals to a computer, which produces images that show the structures in your abdomen.
• Endoscopic ultrasound (EUS). This test can help pinpoint smaller stones that may be missed on an abdominal ultrasound. During endoscopic ultrasound (EUS), the doctor passes a thin, flexible tube (endoscope) through the mouth and the digestive tract. A small ultrasound device (transducer) present in the tube makes sound waves that form a precise image of surrounding tissue.
• Magnetic resonance imaging (MRI). MRI machines utilize radio waves and magnets to create detailed images of the organs and soft tissues without X-rays. MRIs can show cholesterol gallstones in the ducts of the biliary tract.
• Blood tests. Blood tests are not used to directly diagnose cholesterol gallstones but can help assess the function of the liver and pancreas. High liver enzymes or levels of bilirubin may signify complications connected to gallstones, such as inflammation, infection, pancreatitis, or blockage of the bile ducts.
• Oral Cholecystography: This diagnostic test involves ingesting a contrast dye in the form of a tablet. The dye is absorbed by the intestines and passed into bile. X-rays are then taken to visualize the flow of the dye and see any cholesterol gallstones in the gallbladder.
• Cholescintigraphy. Cholescintigraphy or hydroxy iminodiacetic acid scan utilizes a safe radioactive material to create pictures of the biliary tract. The radioactive material is injected into a vein in the arm. A special camera then takes pictures of the radioactive material as it moves through the biliary tract to diagnose abnormal contractions of your gallbladder or a blockage in the bile ducts.
• Percutaneous Transhepatic Cholangiography (PTC): PTC involves injecting a contrast dye into the liver through the skin, guided by imaging techniques such as ultrasound or CT scan. This procedure allows visualization of the bile ducts and can help detect cholesterol gallstones or any obstructions in the biliary system.

Treatment of Cholesterol Gallstone

The usual treatment for cholesterol gallstones is surgery to remove the gallbladder. Surgery to remove the gallbladder, called cholecystectomy, is one of the most common procedures to treat cholesterol gallstones. The gallbladder is not a crucial organ, which means you can live normally without a gallbladder. Surgeons perform two types of cholecystectomy:

1. Laparoscopic cholecystectomy. Laparoscopic cholecystectomy is a minimally invasive surgical procedure commonly used to remove cholesterol gallstones and the gallbladder. It is considered the standard and safest surgical treatment for symptomatic gallstones and has several advantages over traditional open surgery. In this surgery, the surgeon makes 4 to 5 small incisions in the abdomen. These incisions function as access points for the laparoscopic instruments. The surgeon then inserts a laparoscope through one of the incisions and removes your gallbladder through another. Smaller incisions make for less postoperative pain and a faster recovery time than open surgery. Surgeons perform laparoscopic cholecystectomies on an outpatient basis, meaning you may be able to go home the same day. In addition, you can return to regular physical activity in about a week.

2. Open cholecystectomy. Open cholecystectomy or open surgery for cholesterol gallstones is a traditional surgical approach where a larger incision is created in the abdomen to access the gallbladder and execute the removal procedure. While laparoscopic cholecystectomy is the best and most commonly performed method for cholesterol gallstone removal, open surgery may be necessary in certain situations. A surgeon performs an open cholecystectomy when your gallbladder is severely infected, inflamed, or scarred from other operations.
   In this surgery, the surgeon carefully examines and removes the gallbladder from its attachments to the liver and bile ducts. Specialized instruments are used to control bleeding and ensure the complete removal of the gallbladder. After the gallbladder is removed, the incision is closed with sutures or staples. After the open surgery, you may need to stay in the hospital for up to a week. In addition, recovery time may be extended, and there may be more postoperative pain and discomfort due to the larger incision.

How To Prepare For A Cholecystectomy?

Preparing for a cholecystectomy typically involves several steps to ensure a smooth and successful procedure. Here are some general guidelines to help you prepare for the surgery:

• Your healthcare provider will explain the complete surgical procedure to you. Ask him or her any questions you have.
• Eat nothing the night before your surgery. However, you may drink a sip of water with your medications, but avoid eating and drinking at least four to five hours before your surgery.
• Tell your healthcare provider if you are pregnant or think you may be pregnant.
• Abstain from shaving the abdominal area before surgery.
• If you smoke or consume alcohol, it’s essential to quit or significantly reduce your intake before the surgery. Smoking and alcohol can disturb the healing process and increase the risk of complications.
• In the days leading up to your surgery, your surgeon may suggest specific dietary changes. This may involve avoiding fatty or greasy foods that can activate gallstone symptoms. Follow their instructions diligently to help minimize any discomfort.
• Tell your doctor about all the medications and supplements you take. Continue taking most medications as prescribed. However, your doctor may ask you to stop taking certain medications and supplements because they may raise the risk of bleeding.
• Most people can go home the same day of their cholecystectomy, but complications can arise that need one or more nights in the hospital. Therefore, plan ahead if you need to stay in the hospital by bringing personal items, like your toothbrush, comfortable clothing, etc.
• Find someone to drive you home and stay with you.