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Cholecystectomy is the surgical removal of the gallbladder.Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. [1] In 2011, cholecystectomy was the eighth most common operating room procedure performed in hospitals in the United States. [2]
Gallbladder diseases are diseases involving the gallbladder and is closely linked to biliary disease, with the most common cause being gallstones (cholelithiasis). [1] [2]The gallbladder is designed to aid in the digestion of fats by concentrating and storing the bile made in the liver and transferring it through the biliary tract to the digestive system through bile ducts that connect the ...
Most people with gallstones (about 80%) are asymptomatic. [ 2 ] [ 3 ] However, when a gallstone obstructs the bile duct and causes acute cholestasis , a reflexive smooth muscle spasm often occurs, resulting in an intense cramp -like visceral pain in the right upper part of the abdomen known as a biliary colic (or "gallbladder attack"). [ 4 ]
Cholecystitis accounts for 3–10% of cases of abdominal pain worldwide. [43] Cholecystitis caused an estimated 651,829 emergency department visits and 389,180 hospital admissions in the US in 2012. [44] The 2012 US mortality rate was 0.7 per 100,000 people. [44] The frequency of cholecystitis is highest in people age 50–69 years old. [43]
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
The presence of gallstones, usually visualized by ultrasound, generally necessitates a surgical treatment (removal of the gall bladder, typically via laparoscopy). [27] Removal of the gallbladder with surgery, known as a cholecystectomy, is the definitive surgical treatment for biliary colic.
Unlike neonates, hyperbilirubinemia itself requires no treatment in adults. Instead, treatment varies by underlying diseases. As mentioned, cholelithiasis is the most common cause of hyperbilirubinemia. Gallstones can be removed using acid or shock waves in litholytic therapy and lithotripsy, respectively.
Bile duct obstruction, which is usually present in acute cholangitis, is generally due to gallstones. 10–30% of cases, however, are due to other causes such as benign stricturing (narrowing of the bile duct without an underlying tumor), postoperative damage or an altered structure of the bile ducts such as narrowing at the site of an anastomosis (surgical connection), various tumors (cancer ...