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Hello Doctor.My Father Is 56 Years Old He Has Blockage
Question: Hello doctor.My father is 56 years old he has blockage in his heart and has ejection fraction of 25-30 percent.he has undergone angioplasty with two stents.now last month he has episode of Gallbladder stone pain in check ups Acute Cholecystitis came.doc advised for laparoscopic cholescetomy. Surgeon said it is high risk surgery because of heart problem. We r very confused what to do. Please guide us
Hello doctor.My father is 56 years old he has blockage in his heart and has ejection fraction of 25-30 percent.he has undergone angioplasty with two stents.now last month he has episode of Gallbladder stone pain in check ups Acute Cholecystitis came.doc advised for laparoscopic cholescetomy. Surgeon said it is high risk surgery because of heart problem. We r very confused what to do. Please guide us
Brief Answer:
surgery not advisable against the calculated risk as per the narration.
Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read query for your father and here is my advise.
* As per my surgical experience, decision of any high risk surgery must be
precisely evaluated against pros and cons of the outcome overall.
* Mere presence of multiple gall bladder stones do not necessarily mandate
surgery on compulsory basis.
I would like to put up certain basic facts for your understanding and later on give me further details to discuss more precisely.
* A surgery can be delayed or postponed on medical grounds when
- The risk is very high from anesthesia point of view which may endanger
the life of patient ( like in your father`s case with ejection fraction of
25 - 30 % )
- The surgery itself is not life saving and can be kept aside if the medical
management is available to control the symptoms as dietary
modifications, cholesterol control, weight management ( I am not
supposed to convey the cure of disease, but symptoms control )
- Patient and relatives are more comfortable to keep patient happy without
much symptoms rather than endangering by high risk surgery.
* A surgery must be carried out with any level of risk if
- The surgery is life saving and there is no other option than surgery like
bypass for heart condition, multiple fractures of limb with bleeding or else
- Patient and relatives are willing to go for every risk after understanding all
the outcome parts possible via procedure and anesthesia.
- Despite taking all the care and precautions on medical grounds the basic
pathology keep on disturbing the daily routine of the patient as persistent
vomiting, inability to keep food in stomach as in your father`s case.
or medical management is not working at all and symptoms or suffering is
raising day by day.
* Kindly provide me further details so that I can discuss in a bit more detail.
- Current symptoms of your father.
- List of current medications.
* Particularly for cholecystitis I always suggest my patients for a
conservative approach and avoid surgery upto possible as high risk of
surgery is not advantageous over the laparoscopic removal of gall bladder.
Awaiting for your response.
Regards.
Dr Bhagyesh ( MS consultant surgeon )
surgery not advisable against the calculated risk as per the narration.
Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read query for your father and here is my advise.
* As per my surgical experience, decision of any high risk surgery must be
precisely evaluated against pros and cons of the outcome overall.
* Mere presence of multiple gall bladder stones do not necessarily mandate
surgery on compulsory basis.
I would like to put up certain basic facts for your understanding and later on give me further details to discuss more precisely.
* A surgery can be delayed or postponed on medical grounds when
- The risk is very high from anesthesia point of view which may endanger
the life of patient ( like in your father`s case with ejection fraction of
25 - 30 % )
- The surgery itself is not life saving and can be kept aside if the medical
management is available to control the symptoms as dietary
modifications, cholesterol control, weight management ( I am not
supposed to convey the cure of disease, but symptoms control )
- Patient and relatives are more comfortable to keep patient happy without
much symptoms rather than endangering by high risk surgery.
* A surgery must be carried out with any level of risk if
- The surgery is life saving and there is no other option than surgery like
bypass for heart condition, multiple fractures of limb with bleeding or else
- Patient and relatives are willing to go for every risk after understanding all
the outcome parts possible via procedure and anesthesia.
- Despite taking all the care and precautions on medical grounds the basic
pathology keep on disturbing the daily routine of the patient as persistent
vomiting, inability to keep food in stomach as in your father`s case.
or medical management is not working at all and symptoms or suffering is
raising day by day.
* Kindly provide me further details so that I can discuss in a bit more detail.
- Current symptoms of your father.
- List of current medications.
* Particularly for cholecystitis I always suggest my patients for a
conservative approach and avoid surgery upto possible as high risk of
surgery is not advantageous over the laparoscopic removal of gall bladder.
Awaiting for your response.
Regards.
Dr Bhagyesh ( MS consultant surgeon )
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
surgery not advisable against the calculated risk as per the narration.
Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read query for your father and here is my advise.
* As per my surgical experience, decision of any high risk surgery must be
precisely evaluated against pros and cons of the outcome overall.
* Mere presence of multiple gall bladder stones do not necessarily mandate
surgery on compulsory basis.
I would like to put up certain basic facts for your understanding and later on give me further details to discuss more precisely.
* A surgery can be delayed or postponed on medical grounds when
- The risk is very high from anesthesia point of view which may endanger
the life of patient ( like in your father`s case with ejection fraction of
25 - 30 % )
- The surgery itself is not life saving and can be kept aside if the medical
management is available to control the symptoms as dietary
modifications, cholesterol control, weight management ( I am not
supposed to convey the cure of disease, but symptoms control )
- Patient and relatives are more comfortable to keep patient happy without
much symptoms rather than endangering by high risk surgery.
* A surgery must be carried out with any level of risk if
- The surgery is life saving and there is no other option than surgery like
bypass for heart condition, multiple fractures of limb with bleeding or else
- Patient and relatives are willing to go for every risk after understanding all
the outcome parts possible via procedure and anesthesia.
- Despite taking all the care and precautions on medical grounds the basic
pathology keep on disturbing the daily routine of the patient as persistent
vomiting, inability to keep food in stomach as in your father`s case.
or medical management is not working at all and symptoms or suffering is
raising day by day.
* Kindly provide me further details so that I can discuss in a bit more detail.
- Current symptoms of your father.
- List of current medications.
* Particularly for cholecystitis I always suggest my patients for a
conservative approach and avoid surgery upto possible as high risk of
surgery is not advantageous over the laparoscopic removal of gall bladder.
Awaiting for your response.
Regards.
Dr Bhagyesh ( MS consultant surgeon )
surgery not advisable against the calculated risk as per the narration.
Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read query for your father and here is my advise.
* As per my surgical experience, decision of any high risk surgery must be
precisely evaluated against pros and cons of the outcome overall.
* Mere presence of multiple gall bladder stones do not necessarily mandate
surgery on compulsory basis.
I would like to put up certain basic facts for your understanding and later on give me further details to discuss more precisely.
* A surgery can be delayed or postponed on medical grounds when
- The risk is very high from anesthesia point of view which may endanger
the life of patient ( like in your father`s case with ejection fraction of
25 - 30 % )
- The surgery itself is not life saving and can be kept aside if the medical
management is available to control the symptoms as dietary
modifications, cholesterol control, weight management ( I am not
supposed to convey the cure of disease, but symptoms control )
- Patient and relatives are more comfortable to keep patient happy without
much symptoms rather than endangering by high risk surgery.
* A surgery must be carried out with any level of risk if
- The surgery is life saving and there is no other option than surgery like
bypass for heart condition, multiple fractures of limb with bleeding or else
- Patient and relatives are willing to go for every risk after understanding all
the outcome parts possible via procedure and anesthesia.
- Despite taking all the care and precautions on medical grounds the basic
pathology keep on disturbing the daily routine of the patient as persistent
vomiting, inability to keep food in stomach as in your father`s case.
or medical management is not working at all and symptoms or suffering is
raising day by day.
* Kindly provide me further details so that I can discuss in a bit more detail.
- Current symptoms of your father.
- List of current medications.
* Particularly for cholecystitis I always suggest my patients for a
conservative approach and avoid surgery upto possible as high risk of
surgery is not advantageous over the laparoscopic removal of gall bladder.
Awaiting for your response.
Regards.
Dr Bhagyesh ( MS consultant surgeon )
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
follow up .
Detailed Answer:
Hi
Thanks for the follow up.
* As there are no symptoms at present that means that the gall stones are
not pausing the issue for which a risk of life and death should be counted.
* I have came across hundreds of patients with gall stones living happily
without symptoms just by managing diet and rest of the stuffs.
So far as the risk percentage is concerned, it is calculated by physical examination of the patient with co relation of supportive data facts of reports.
Any normal person is also having calculated risk to surgery and anesthesia, but the underlying medical issues of heart problem and others make one person more prone and likelihood for getting problems as compared to normal person.
Exact percentage would not be possible to quote from this ground by online consultation, but over all I will tell that there is more than double risk of average person to your father if he goes for surgery under general anesthesia and once he goes in complications during or after surgery, chances of revival and outcome are very guarded from medical point of view.
Again I will stick to my previous quote of not having high risk surgery for asymptomatic gall stones at present.
Let the time decide the future need of surgery.
Wish your father best health.
Regards.
follow up .
Detailed Answer:
Hi
Thanks for the follow up.
* As there are no symptoms at present that means that the gall stones are
not pausing the issue for which a risk of life and death should be counted.
* I have came across hundreds of patients with gall stones living happily
without symptoms just by managing diet and rest of the stuffs.
So far as the risk percentage is concerned, it is calculated by physical examination of the patient with co relation of supportive data facts of reports.
Any normal person is also having calculated risk to surgery and anesthesia, but the underlying medical issues of heart problem and others make one person more prone and likelihood for getting problems as compared to normal person.
Exact percentage would not be possible to quote from this ground by online consultation, but over all I will tell that there is more than double risk of average person to your father if he goes for surgery under general anesthesia and once he goes in complications during or after surgery, chances of revival and outcome are very guarded from medical point of view.
Again I will stick to my previous quote of not having high risk surgery for asymptomatic gall stones at present.
Let the time decide the future need of surgery.
Wish your father best health.
Regards.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
follow up .
Detailed Answer:
Hi
Thanks for the follow up.
* As there are no symptoms at present that means that the gall stones are
not pausing the issue for which a risk of life and death should be counted.
* I have came across hundreds of patients with gall stones living happily
without symptoms just by managing diet and rest of the stuffs.
So far as the risk percentage is concerned, it is calculated by physical examination of the patient with co relation of supportive data facts of reports.
Any normal person is also having calculated risk to surgery and anesthesia, but the underlying medical issues of heart problem and others make one person more prone and likelihood for getting problems as compared to normal person.
Exact percentage would not be possible to quote from this ground by online consultation, but over all I will tell that there is more than double risk of average person to your father if he goes for surgery under general anesthesia and once he goes in complications during or after surgery, chances of revival and outcome are very guarded from medical point of view.
Again I will stick to my previous quote of not having high risk surgery for asymptomatic gall stones at present.
Let the time decide the future need of surgery.
Wish your father best health.
Regards.
follow up .
Detailed Answer:
Hi
Thanks for the follow up.
* As there are no symptoms at present that means that the gall stones are
not pausing the issue for which a risk of life and death should be counted.
* I have came across hundreds of patients with gall stones living happily
without symptoms just by managing diet and rest of the stuffs.
So far as the risk percentage is concerned, it is calculated by physical examination of the patient with co relation of supportive data facts of reports.
Any normal person is also having calculated risk to surgery and anesthesia, but the underlying medical issues of heart problem and others make one person more prone and likelihood for getting problems as compared to normal person.
Exact percentage would not be possible to quote from this ground by online consultation, but over all I will tell that there is more than double risk of average person to your father if he goes for surgery under general anesthesia and once he goes in complications during or after surgery, chances of revival and outcome are very guarded from medical point of view.
Again I will stick to my previous quote of not having high risk surgery for asymptomatic gall stones at present.
Let the time decide the future need of surgery.
Wish your father best health.
Regards.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Right now my father has no other symptoms. For gallbladder he is not taking any medicine but taking only heArt medication. How much risk is involved in the surgery?
Right now my father has no other symptoms. For gallbladder he is not taking any medicine but taking only heArt medication. How much risk is involved in the surgery?
Hi, I have provided some attachments. Please review them.
Hi, I have provided some attachments. Please review them.
Hi, I have provided some attachments. Please review them.
Hi, I have provided some attachments. Please review them.
Brief Answer:
follow up .
Detailed Answer:
Hi
Thanks for the attachment, I have reviewed current heart status of uncle from that.
* The risk involved in surgery is already discussed in previous session only.
* Again I repeat that calculated risk is very very high as compared to normal
person and I do not agree to undergo that decision at this point of time.
Regards.
follow up .
Detailed Answer:
Hi
Thanks for the attachment, I have reviewed current heart status of uncle from that.
* The risk involved in surgery is already discussed in previous session only.
* Again I repeat that calculated risk is very very high as compared to normal
person and I do not agree to undergo that decision at this point of time.
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
follow up .
Detailed Answer:
Hi
Thanks for the attachment, I have reviewed current heart status of uncle from that.
* The risk involved in surgery is already discussed in previous session only.
* Again I repeat that calculated risk is very very high as compared to normal
person and I do not agree to undergo that decision at this point of time.
Regards.
follow up .
Detailed Answer:
Hi
Thanks for the attachment, I have reviewed current heart status of uncle from that.
* The risk involved in surgery is already discussed in previous session only.
* Again I repeat that calculated risk is very very high as compared to normal
person and I do not agree to undergo that decision at this point of time.
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you so much doctor..
Thank you so much doctor..
Brief Answer:
most welcome
Detailed Answer:
Welcome.
Do feel free to discuss further at any point of time.
Regards
most welcome
Detailed Answer:
Welcome.
Do feel free to discuss further at any point of time.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
most welcome
Detailed Answer:
Welcome.
Do feel free to discuss further at any point of time.
Regards
most welcome
Detailed Answer:
Welcome.
Do feel free to discuss further at any point of time.
Regards
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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