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Suggest Treatment For Gall Bladder Stones

Posted on Thu, 23 Apr 2015

Question: Dear Doctor
I work in the merchant navy.Recently one of the new tests being carried out for our medicals is the Sonagraphy test.In my last 37years at sea these tests were not carried out.As per the test carried out have informed me that there are a few small stones in the gall bladder.The medical doctors have advised me to go in for surgery that would involve removing the gall bladder. They have advised me i need to do that before i sail again as repercussion of not doing it could be dangerous.They have not given me a report but I had carried out a test recently prior to this merchant navy medical examination,which I shall forward.These stones have been there for the last 10-14 years and i have consulted some doctors in the past who have said you may keep monitoring it for the size and accordingly take a decision whether you want to operate.Anyhow now as per new regulations the doctors do not clear the sailor fit to sail.
Can you advise what are my options?Do i need to go for the operation/surgery of removing the gall bladder?
what are the success rates of this operation?
Are there any other tests/checks to be carried out prior to doing the operation?Any other precautions or questions i would need to confirm with the doctor prior going in for the operation?
Which specialist do these operations?Gastrointestinal specialist?
How long do these operations take and after how many days you will be discharged?
When can i join back sailing?
I would appreciate your views/advice.
Thanks/regards
XXXX

Answered by Dr. Ajit Naniksingh Kukreja (3 hours later)

Brief Answer:
Should go for Laparoscopic Surgery

Detailed Answer:
Hi XXXXXXX

Thanks for writing in

Basically the medical doctors are right
Multiple small gall stones can cause obstructive jaundice which has more morbidity than a regular gall bladder surgery

Because there are polyps also it is advisable to get it removed

PSA is normal

With advances in hepatobiliary surgery Gall bladder removal has been a day care procedure

A surgical gastroentrologist with exposure to laparoscopy surgery should be able to handle your case

Success in experienced hands is nearly 100 percent

A major preoperative profile and ultrasound will be needed

Surgery will last for around an hour and you can be back home same evening

You can be back sailing after a week or ten days

Hope this clears your doubts
Do not hesitate to write back in case of concern

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Ajit Naniksingh Kukreja (17 hours later)

Dear Doctor Kukreja,
Thanks for your advice.I have a few questions/concerns.

1.Can you kindly explain in detail your statement "Multiple small gall stones can cause obstructive jaundice which has more morbidity than a regular gall bladder surgery."

2.Just to give some more information about myself I am 167cms tall and weigh abt 85/86kgs but otherwise fairly active.Could this be a concern?

3.What are the effects of not having a gall bladder?Will a person still be able to lead a normal active life like doing brisk walking,carrying medium weights etc.

4.I understand one of the causes for creation of gall stones is the diet or food a person eats.With respect to the post operation do I need to follow a particular diet.I ask this as when I get back to sailing I would need to follow a diet and sometimes that would be difficult.

5.Although you have assured me that these operations are almost 100 percent but I would presume the surgeon would need to have a good ultrasound done in order to know how to go about it and if there are any concerns and complications that could arise.

Sir,I would appreciate your advice on the above even though it may involve repeating yourself.

Thank you,

Regards

XXXX

Answered by Dr. Ajit Naniksingh Kukreja (4 hours later)

Brief Answer:
Reassure yourself

Detailed Answer:
Hi XXXXXXX
Thanks for writing in again

Here is my response to your queries :

1]Small multiple gall stones can move out of gallbladder through common bile duct and obstruct biliary damage causing obstructive jaundice, the surgery for that is preceded by endoscopic removal of stone from CBD and stenting followed by gall bladder removal

2]Should not be a concern

3]Can lead normal life

4]No dietry inhibitions after surgery, just avoid, fried and fermented junk food

5]Experience in Laparoscopy is more vital though a good ultrasound is equally important

Hope this clears your doubts
Wishing you a healthy life ahead

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ajit Naniksingh Kukreja (3 days later)

Dear Doctor Kukreja,
Thanks for your advice.
I have consulted a Doctor and as per his advice have redone a sonography test prior going in for the operation.

The final report is not out but the Ultrasound doctor told me there is no evidence of gall stones but sludge is noted.

The Gasterointestinal surgeon has told me since i am working in the merchant navy it is advisable to go in for the gall bladder removal.If i was ashore he said there is no need to bother about it.

There are tiny polyps noted in the test.

Also he has mentioned "B/L increased cortical echogenocity"

Final reports will be out tomorrow.

Kindly advise your opinion whether surgery still advisable.

Thank you

Regards

XXXX

Answered by Dr. Ajit Naniksingh Kukreja (3 hours later)

Brief Answer:
Yes You Should

Detailed Answer:
Hi

Thanks for your followup query

I would suggest irrespective of the fact that you are in Navy you should go for the surgery

The last case I did had obstructive jaundice because of sludge and I had to do an ERCP in emergency

Do send me the reports once they are with you

Regards
Wishing you a healthy life ahead

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ajit Naniksingh Kukreja (21 hours later)

Dear Doctor Kukreja,

Thanks for your advice.

Please find attached the USG and blood test reports.

Kindly review the same and appreciate your comments.

Thank you

Regards

XXXX

Answered by Dr. Ajit Naniksingh Kukreja (2 hours later)

Brief Answer:
Go for Surgery

Detailed Answer:
Hi XXXXXXX

Thanks for sharing the reports with me

It is better you get operated and get the gall bladder removed

If used to consuming alcohol, please avoid doing so

Blood reports and x ray chest are normal so you are fit for anesthesia, yet had it been me I would go for a major preoperative profile along with Liver function test and a RS/CVS assessment by a physician before planning the surgery

Hope this clears your doubts
Do not hesitate to revert back in case you need any clarification

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Prasad