Surgical Removal of Gallstones - Laparoscopic cholecystectomy

• Gallstones may present symptoms similar to gastritis, such as stomach pain, indigestion, bloating and gas. Taking oral drugs could actually result in the condition worsening.
• Frequent consumption of fatty foods can increase the chances of developing gallstones.
• Treating gallstones with oral medication is usually ineffective due to their inability to break up the stones. Furthermore, when such medication is halted, new stones may appear, meaning surgery to remove gallstones is the most effective form of treatment for the condition.

Gallstones occur due to chemical imbalances in the gallbladder, including imbalances of chemicals such as cholesterol, phosphate and bile. These imbalances may result in a sludge and, eventually, form gallstones. Such stones may be small or large, with the number of stones formed differing from case to case. Nevertheless, if a stone is left untreated, it will likely increase in size.

Gallstones are more common among women than men, with those aged between 30–50 most at risk. The symptoms are similar to those associated with gastritis, meaning the condition is often not viewed as dangerous, leading many people to purchase their own over-the-counter medication to treat the condition. However, gallstones can be extremely dangerous. If you detect any of the following symptoms, you should seek diagnosis within 1–2 weeks:

• Severe gas and bloating
• Indigestion, usually happens after eating a fatty meal
• Stomach pain emanating from the right ribs that spreads to the shoulders and right side of the back

If these symptoms are left untreated, they could result in other complications, including cholecystitis, with the gallstone becoming dislodged, leading to a bile duct blockage, or inflamed pancreas. Other symptoms may also present themselves, such as fever, nausea, vomiting, jaundice or darkened urine. In cases where the stomach pain is severe enough to incapacitate the patient, it is essential that the patient be brought to the hospital within 24 hours.

• Being obese or overweight
• Eating a diet high in fatty foods
• Being over the age of 40
• Being female, especially those who take estrogen
• Having side effects associated with some forms of lipid-lowering drugs
• Rapid weight loss
• Blood disorders which involve red blood cells breaking up faster than usual, such as thalassemia

Doctors will initially inquire about a patient’s medical history, carry out a full body checkup and take a sample of blood for analysis. If the patient is found to be at risk of gallstones, an additional ultrasound scan of their abdomen may be necessary, which would require them to fast for at least six hours prior to the procedure. The ultrasound scan is both quick and accurate, providing over 80% more detail when compared with other methods.

Statistics related to the treatment of gallstones show that taking oral medication is not generally effective due to its inability to break up the stones properly. Moreover, when the taking of such medication is discontinued, there is a risk that new stones will begin to form. Shockwave therapy aimed at breaking up the stones has been found to be effective on those located in the bile ducts, although this treatment is not of use when treating stones located in the gallbladder.

Doctors therefore recommend surgical removal of gallstones as an extremely effective form of treatment, especially the laparoscopic cholecystectomy procedure, which is a form of minimally invasive surgery (MIS) that offers much less pain when compared to open forms of abdominal surgery.

However, in patients who suffer from other complications related to gallstones, including a severely swollen gallbladder or a thick membrane surrounding the organ, surgeons will be unable to identify the nearby organs properly, meaning that open abdominal surgery may be the only viable option available.

Currently, the laparoscopic cholecystectomy procedure is preferable as it is, both, highly effective and low risk due to the incision made measuring a mere 0.5 cm, meaning that patients can make a speedy recovery, often returning home within 1–2 days after the procedure.

A laparoscopic cholecystectomy involves making three to four tiny incisions, one near the belly button and two to three under the right side of the rib cage, to enable the insertion of the small camera and device used to survey the gallbladder. These instruments are used to cut the gallbladder, put it in a retrieval bag, and removed. The surgeons will then remove the camera and device and finally complete the procedure by stitching the patient’s wounds.

Although a laparoscopic cholecystectomy has an almost 95% chance of success, patients who have suffered from acute cholecystitis for over three days, as well as those with underlying health conditions, may have a lower chance with laparoscopic surgery being successful. Doctor will therefore carefully consider each case before deciding on whether to operate.

Thus, if you start to experience symptoms that make you suspect gallstones, you must not ignore them or leave them untreated for a prolonged period, as this could reduce your chances of opting for laparoscopic surgery.

Patients undergoing gallbladder surgery are required to stay in hospital for two days and are unable to work for approximately one week. However, at Samitivej Hospital, our surgeons offer the most advanced minimally invasive technology, laparoscopic cholecystectomy. Utilizing 3D-4K technology gives a clearer view of fine detail and greater depth perception; providing a more realistic visualization of complex surgical procedures. It also allows zooming in without pixelation, for a magnified view.

This advanced technology requires an incision of about 1 centimeter to conduct the surgery. With the support of high-grade 4K medical monitors, surgeons have the ability to see all the details required to perform their surgery safely and efficiently. Before the commencement of surgery, patients will be administered with general anesthesia to ensure their comfort during the procedure. Surgeons will then delicately separate the gallbladder from the liver and bile ducts in preparation for its removal, subsequently via the initial small incision. By utilizing the latest minimally invasive technology, Samitevej’s patients can undergo surgery, knowing that they’ll be in safe hands and back at work in no time.

• Treatment Plan Consultation with a doctor via online video-call (second opinion)
• Treatment Planning if you have medical records or a price estimate from another hospital
• Cost Planning by our Appraisals Team with price guarantee (only for procedure packages without complications)
• Check Initial Coverage Eligibility with Thai and international insurance companies (only for insurance companies in contract with the Hospital)

You can consult our specialist online to find out about the treatment options most suitable for your condition via Samitivej Virtual Hospital. To schedule an appointment or for more information CLICK HERE.

Pakpong Wathanaoran, M.D.

Pakpong Wathanaoran, M.D. is a surgeon at Samitivej Sukhumvit Hospital with over 10 years experience in hernia repair, laparoscopic and abdominal surgeries. He has treated over 500 patients with hernia. Even with such experience, Dr. Pakpong continues to invest time in medical academia by participating in workshops and seminars such as ‘The 2nd Phuket International Symposium in Colorectal Disease, Bangkok Hospital Phuket’ and ‘D2 Gastrectomy, Upper GI Surgery Society of Thailand, Faculty of Medicine Siriraj Hospital’, amongst many others to stay up to date with the latest innovations in the field. To schedule an appointment with Dr. Pakpong, CLICK HERE