"the bile duct. Pain and complications caused by gallstones are the most common reasons for removal of the gallbladder. The gallbladder can also be removed in order to treat biliary dyskinesia or gallbladder cancer. Gallstones are incredibly common but 50–80% of people with gallstones are asymptomatic and do not need surgery; their stones are noticed incidentally on imaging tests of the abdomen (such as ultrasound or CT) done for some other reason. Of the more than 20 million people in the US with gallstones, only about 30% will eventually require cholecystectomy to relieve symptoms (pain) or treat complications. Biliary colic,"
"the surgery a cholecystectomy is performed to remove the gallbladder. This portion is not done en bloc, as the gallbladder is removed separately. Relevant nearby anatomy not removed during the procedure include the major vascular structures in the area: the portal vein, the superior mesenteric vein, and the superior mesenteric artery, the inferior vena cava. These structures are important to consider in this operation especially if done for resection of a tumor located in the head of the pancreas. If the tumor encases (wraps around 50% or more of the vessel) the celiac artery, superior mesenteric artery, or inferior vena"
"removed. It may be removed because of recurrent gallstones, and is considered an elective procedure. A cholecystectomy may be an open procedure, or one conducted by laparoscopy. In the surgery, the gallbladder is removed from the neck to the fundus, and so bile will drain directly from the liver into the biliary tree. About 30 percent of patients may experience some degree of indigestion following the procedure, although severe complications are much rarer. About 10 percent of surgeries lead to a chronic condition of postcholecystectomy syndrome. Cancer of the gallbladder is uncommon and mostly occurs in later life. When cancer"
"cases, the removal of the colon may entirely cure the disease. A colectomy may also be utilized in the treatment of colon cancer. Extirpation of the gallbladder, known as a cholecystectomy, may be used as a treatment for recurrent gallstones or cholecystitis. This type of procedure is typically elective and outcomes following the procedure are typically good. The rate of cholecystectomies being performed on patients with cholecystitis has increased markedly since the first laparoscopic procedure was performed in 1985; jumping from 2.2% in 1996 to 31.4% in 2008. Surgical extirpation Surgical extirpation is a type of occasionally invasive surgical procedure"
"from the stomach with an OG or NG tube. A Foley catheter may be used to empty the patient's bladder. Laparoscopic cholecystectomy uses several (usually 4) small incisions in the abdomen to allow the insertion of operating ports, small cylindrical tubes approximately 5 to 10 mm in diameter, through which surgical instruments are placed into the abdominal cavity. The laparoscope, an instrument with a video camera and light source at the end, illuminates the abdominal cavity and sends a magnified image from inside the abdomen to a video screen, giving the surgeon a clear view of the organs and tissues."
"Congress in 1992. Philippe Mouret performed laparascopic cholecystectomy on March 17, 1987 in Lyon, France. His technique was rapidly adopted and improved in France. It was subsequently introduced to the rest of the world over the next three years. Driven by popularity among patients, the laparascopic technique became preferred over open surgery and noninvasive treatments for gallstones. By 2013, laparoscopic cholecystectomy had replaced open cholecystectomy as the first-choice of treatment for people with uncomplicated gallstones and acute cholecystitis. By 2014 laparoscopic cholecystectomy had become the gold standard for the treatment of symptomatic gallstones. Cholecystectomy Cholecystectomy is the surgical removal of"
"bowel obstructions and organ perforations are the main problems they deal with. Cholecystectomy, the surgical removal of the gallbladder, is one of the most common surgical procedures done worldwide. This is most often done electively, but the gallbladder can become acutely inflamed and require an emergency operation. Infections and rupture of the appendix and small bowel obstructions are other common emergencies. This is a relatively new specialty dealing with minimal access techniques using cameras and small instruments inserted through 3 to 15mm incisions. Robotic surgery is now evolving from this concept (see below). Gallbladders, appendices, and colons can all be"
"causing a blockage to allow drainage, it cannot remove all stones in the gallbladder. Thus, it is not considered a definitive treatment and people with recurrent complications from stones will still likely need a cholecystectomy. Cholecystostomy is the drainage of the gallbladder via insertion of a small tube through the abdominal wall. This is usually done using guidance from imaging scans to find the right place to insert the tube. Cholecystostomy can be used for people who need immediate drainage of the gallbladder but have a high risk of complications from surgery under general anaesthesia, such as elderly people and"
"those with co-existing illnesses. Draining pus and infected material through the tube reduces inflammation in and around the gallbladder. It can be a lifesaving procedure, without requiring that the person undergo emergency surgery. The procedure does come with significant risks and complications—in one retrospective study of patients who received percutaneous cholecystostomy for acute cholecystitis, 44% developed choledocholithiasis (one or more stones stuck in the common bile duct), 27% had tube dislodgment, and 23% developed postoperative abscess. For some people, drainage with cholecystostomy is enough and they don't need to have the gallbladder removed later. For others, percutaneous cholecystostomy allows them"
"cannot tolerate surgery under general anesthesia should not undergo cholecystectomy. People can be split into high and low risk groups using a tool such as the ASA physical status classification system. In this system, people who are ASA categories III, IV, and V are considered high risk for cholecystectomy. Typically this includes very elderly people and people with co-existing illness, such as end-stage liver disease with portal hypertension and whose blood does not clot properly. Alternatives to surgery are briefly mentioned below. All surgery carries risk of serious complications including damage to nearby structures, bleeding, infection, or even death. The"
"trocars (hollow tubes with a seal to keep the from leaking). Over one million cholecystectomies are performed in the U.S. annually, with over 96% of those being performed laparoscopically. Rather than a minimum 20 cm incision as in traditional (open) cholecystectomy, four incisions of 0.5–1.0 cm, or more recently a single incision of 1.5–2.0 cm, will be sufficient to perform a laparoscopic removal of a gallbladder. Since the gallbladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through"
"disease, or rapid weight loss. Occasionally acute cholecystitis occur as a result of vasculitis, chemotherapy, or during recovery from major trauma or burns. Cholecystitis is suspected based on symptoms and laboratory testing. Abdominal ultrasound is then typically used to confirm the diagnosis. Treatment is usually with laparoscopic gallbladder removal, within 24 hours if possible. Taking pictures of the bile ducts during the surgery is recommended. The routine use of antibiotics is controversial. They are recommended if surgery cannot occur in a timely manner or if the case is complicated. Stones in the common bile duct can be removed before surgery"
"the recurrence of cholelithiasis. The lack of a gallbladder may have no negative consequences in many people. However, there is a portion of the population—between 10 and 15%—who develop a condition called postcholecystectomy syndrome which may cause gastrointestinal distress and persistent pain in the upper-right abdomen, as well as a 10% risk of developing chronic diarrhea. There are two surgical options for cholecystectomy: Cholesterol gallstones can sometimes be dissolved with ursodeoxycholic acid taken by mouth, but it may be necessary for the person to take this medication for years. Gallstones may recur, however, once the drug is stopped. Obstruction of"
"known as a cholecystectomy, is the definitive surgical treatment for biliary colic. A 2013 Cochrane review found tentative evidence to suggest that early gallbladder removal may be better than delayed removal. Early laparoscopic cholescystectomy happens within 72 hours of diagnosis. In a Cochrane review that evaluated receiving early versus delayed surgery, they found that 23% of those who waited on average 4 months ended up in hospital for complications, compared to none with early intervention with surgery. Early intervention has other advantages including reduced number of visits to the emergency department, fewer conversions to an open surgery, less operating time"
"gallbladder, fistulization of gallbladder and gallstone ileus, cholangitis, cirrhosis or portal hypertension, and blood dyscrasias. After removal, the gallbladder should be sent for pathological examination to confirm the diagnosis and look for any incidental cancer. Incidental cancer of the gallbladder is found in approximately 1% of cholecystectomies. If cancer is present in the gallbladder, it's usually necessary to re-operate to remove parts of the liver and lymph nodes and test them for additional cancer. After surgery, most patients are admitted to the hospital for routine monitoring. For uncomplicated laparoscopic cholecystectomies, people may be discharged on the day of surgery after"
"If biliary injuries are properly treated and repaired, more than 90% of patients can have a long-term successful recovery. A review of safety data in laparoscopic cholecystectomy found the following complications to be most common: The same study found the prevalence of bowel injury, sepsis, pancreatitis, and deep vein thrombosis/pulmonary embolism to be around 0.15% each. Leakage from the stump of the cystic duct is a complication that is more common with the laparoscopic approach than the open approach but is still rare, occurring in less than 1% of procedures; it is treated by drainage followed by insertion of a"
"the HAI pump, the patients undergo an arteriogram to outline the blood supply of the liver and to identify any anatomical anomalies. The procedure begins with an exploratory laparotomy to confirm the unresectable nature of the tumor, and then the gallbladder is removed by performing a cholecystectomy. This is done to prevent treatment induced cholecystitis. The distal gastroduodenal artery, the right gastric artery, and small branches supplying the stomach and duodenum are ligated. This total devascularization of the distal stomach and proximal duodenum minimizes the risk of any extra hepatic perfusion. The catheter is placed at the junction of the"
"confirmed that the bile duct is clear of gallstones. Those who do not undergo cholecystectomy have an increased risk of recurrent biliary pain, jaundice, further episodes of cholangitis, and need for further ERCP or cholecystostomy; the risk of death is also significantly increased. Acute cholangitis carries a significant risk of death, the leading cause being irreversible shock with multiple organ failure (a possible complication of severe infections). Improvements in diagnosis and treatment have led to a reduction in mortality: before 1980, the mortality rate was greater than 50%, but after 1980 it was 10–30%. Patients with signs of multiple organ"
"Cystectomy Cystectomy is a medical term for surgical removal of all or part of the urinary bladder. It may also be rarely used to refer to the removal of a cyst. The most common condition warranting removal of the urinary bladder is bladder cancer. Two main types of cystectomies can be performed. A partial cystectomy (also known as a segmental cystectomy) involves removal of only a portion of the bladder. A radical cystectomy involves removal of the entire bladder along with surrounding lymph nodes and other nearby organs that contain cancer. Evaluation of the tissue removed during cystectomy and lymph"
"shake) is then given and more imaging is performed for another hour so that the response to the fatty meal by the gall bladder can be shown. The gall bladder should respond and begin emptying into the duodenum, the amount of bile ejected can then be calculated as an ejection fraction (EF). An EF < 35% is considered to be diagnostic of biliary dyskinesia and suitable for cholecystectomy to be considered. Laparoscopic cholecystectomy has been used to treat the condition when due to dyskinesia of the gallbladder. Symptoms may persist after cholecystectomy, and have been linked to the use of"
"of the ear or with a CT (Computed tomography) Scan. Cholesteatoma is a persistent disease. Once the diagnosis of cholesteatoma is made in a patient who can tolerate a general anesthetic, the standard treatment is to surgically remove the growth. The challenge of cholesteatoma surgery is to permanently remove the cholesteatoma whilst retaining or reconstructing the normal functions of the structures housed within the temporal bone. The general objective of cholesteatoma surgery has two parts. It is both directed against the underlying pathology and directed towards maintaining the normal functions of the temporal bone. These aims are conflicting and this"
"or gangrene are suspected. Many other diagnoses can have similar symptoms as cholecystitis. Additionally the symptoms of chronic cholecystitis are commonly vague and can be mistaken for other diseases. These alternative diagnoses include but are not limited to: For most people with acute cholecystitis, the treatment of choice is surgical removal of the gallbladder, laparoscopic cholecystectomy. Laparoscopic cholecystectomy is performed using several small incisions located at various points across the abdomen. Several studies have demonstrated the superiority of laparoscopic cholecystectomy when compared to open cholecystectomy (using a large incision in the right upper abdomen under the rib cage). People undergoing"
"words, the aims of cholesteatoma treatment form a hierarchy. The paramount objective is the complete removal of cholesteatoma. The remaining objectives, such as hearing preservation, are subordinate to the need for complete removal of cholesteatoma. This hierarchy of aims has led to the development of a wide range of strategies for the treatment of cholesteatoma. The variation in technique in cholesteatoma surgery results from each surgeon's judgment whether to retain or remove certain structures housed within the temporal bone in order to facilitate the removal of cholesteatoma. This typically involves some form of mastoidectomy which may or may not involve"
"colic can be managed with pain medications like NSAIDS (ex: ketorolac) or opioids. Conservative management for acute cholecystitis involves treating the infection without surgery. It is usually only considered in patients at very high risk for surgery or other interventions listed below. It consists of treatment with intravenous antibiotics and fluids. ERCP, short for endoscopic retrograde cholangiopancreatography, is an endoscopic procedure that can remove gallstones or prevent blockages by widening parts of the bile duct where gallstones frequently get stuck. ERCP is often used to retrieve stones stuck in the common bile duct in patients with gallstone pancreatitis or cholangitis."
"operative death rate in cholecystectomy is about 0.1% in people under age 50 and about 0.5% in people over age 50. The greatest risk of death comes from co-existing illness like cardiac or pulmonary disease. A serious complication of cholecystectomy is biliary injury, or damage to the bile ducts. Laparoscopic cholecystectomy has a higher risk of bile duct injury than the open approach, with injury to bile ducts occurring in 0.3% to 0.5% of laparoscopic cases and 0.1% to 0.2% of open cases. In laparoscopic cholecystectomy, approximately 25-30% of biliary injuries are identified during the operation; the rest become apparent"
"Coccygectomy Coccygectomy is a surgical procedure in which the coccyx or tailbone is removed. It is considered a required treatment for sacrococcygeal teratoma and other germ cell tumors arising from the coccyx. Coccygectomy is the treatment of last resort for coccydynia (coccyx pain) which has failed to respond to nonsurgical treatment. Non surgical treatments include use of seat cushions, external or internal manipulation and massage of the coccyx and the attached muscles, medications given by local injections under fluoroscopic guidance, and medications by mouth. To remove the coccyx, an incision is made from the tip of the coccyx to its"
"Cholecystography Oral cholecystography is a radiological procedure used to visualize the gallbladder and biliary channels, developed in 1924 by American surgeons Evarts Ambrose Graham and Warren Henry Cole. It is usually indicated in cases of suspected gallbladder disease, and can also be used to determine or rule out the presence of intermittent obstruction of the bile ducts or recurrent biliary disease after biliary surgery. A radiopaque cholegraphic (contrast) agent, usually iopanoic acid (Telepaque) or its sodium or calcium salt, is orally administered, which is absorbed by the intestine. This excreted material will collect in the gallbladder, where reabsorption of water"
"own potential complications. Thus, if the suspicion is low, the physician may choose to confirm the diagnosis with MRCP, a non-invasive imaging technique, before proceeding with ERCP or surgery. Treatment involves an operation called a choledocholithotomy, which is the removal of the gallstone from the bile duct using ERCP, although surgeons are now increasingly using laparoscopy with cholangiography. In this procedure, tiny incisions are made in the abdomen and then in the cystic duct that connects the gallbladder to the bile duct, and a thin tube is introduced to perform a cholangiography. If stones are identified, the surgeon inserts a"
"surgeon washes the area with saline solution and closes the various layers of tissues and skin with various types of sutures. The wound is then covered with sterile gauze and bandaged. Orchiectomy has adverse effects such as sterility, hypoandrogenism and hypoestrogenism, associated symptoms such as hot flashes, osteoporosis, demasculinization, sexual dysfunction, and depression, as well as gynecomastia (1 to 14%). Orchiectomy Orchiectomy (also named orchidectomy, and sometimes shortened as orchi) is a surgical procedure in which one or both testicles are removed. The removal of both testicles (bilateral orchiectomy) is the surgical form of castration. There are three main types"
"Postcholecystectomy syndrome Postcholecystectomy syndrome describes the presence of abdominal symptoms, two years after a cholecystectomy (gall bladder removal). Symptoms occur in about 5 to 40 percent of patients who undergo cholecystectomy, and can be transient, persistent or lifelong. The chronic condition is diagnosed in approximately 10% of postcholecystectomy cases. The pain associated with postcholecystectomy syndrome is usually ascribed to either sphincter of Oddi dysfunction or to post-surgical adhesions. A recent study shows that postcholecystectomy syndrome can be caused by biliary microlithiasis. Approximately 50% of cases are due to biliary causes such as remaining stone, biliary injury, dysmotility, and choledococyst. The"
"decrease the risk of spontaneous abortion and pre-term delivery. Without cholecystectomy, more than half of such women will have recurrent symptoms during their pregnancy, and nearly one in four will develop a complication, such as acute cholecystitis, that requires urgent surgery. Acute cholecystitis is the second most common cause of acute abdomen in pregnant women after appendectomy. Porcelain gallbladder (PGB), a condition where the gallbladder wall shows calcification on imaging tests, was previously considered a reason to remove the gallbladder because it was thought that people with this condition had a high risk of developing gallbladder cancer. However, recent studies"
"makes cholesteatoma surgery extremely challenging. Sometimes, the situation results in a clash of surgical aims. The need to fully remove a progressive disease like cholesteatoma is the surgeon's first priority. Preservation of hearing is secondary to this primary aim. If the disease can be removed easily so that there is no increased risk of residual disease, then the ossicles may be preserved. If the disease is difficult to remove, so that there is an increased risk of residual disease, then removal of involved ossicles in order to fully clear cholesteatoma has generally been regarded as necessary and reasonable. In other"
"joint with the sacrum. The coccyx is cut away from the surrounding tissues, cut off at the joint with the sacrum, and removed. If the tip of the sacrum is rough, it is filed down. The wound is closed in layers. As with any operation under anaesthetic, there are risks associated with general anaesthesia itself. An additional possible complication of coccygectomy is infection at the surgical site, due to the site's proximity to the anus, leading to contamination by bacteria from the patient's feces. An analysis of 24 studies of coccygectomy (covering 702 patients) reported that 19 studies (covering 493"