Doss India - Gall Stones, Gall Bladder Surgery Treatment in Pune, Maharashtra - PowerPoint PPT Presentation

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Doss India - Gall Stones, Gall Bladder Surgery Treatment in Pune, Maharashtra


Dr. Satish Pattanshetti and Dr. Neeraj V Rayate is best Gall Bladder Surgeon, Gall Stone, Diabetes & Obesity surgeon in pune – PowerPoint PPT presentation

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Title: Doss India - Gall Stones, Gall Bladder Surgery Treatment in Pune, Maharashtra

Anatomy of gallbladder and extrahepatic biliary
  • Bile
  • Helps the body digest fats
  • Made in the liver
  • Stored in the gallbladder until the body needs it
  • Contains
  • Water
  • Cholesterol
  • Bile pigments
  • Phospholipids
  • Bicarbonate
  • Anions of the bile acids
  • Concentrations vary - different kinds of stones
    may be formed
What are gallstones?
  • Small, pebble-like substances
  • Multiple or solitary
  • May occur anywhere within the biliary tree
  • Have different appearance - depending on their
Pigment stones
  • Small
  • Friable
  • Irregular
  • Dark
  • Made of bilirubin and calcium salts
  • Less than 20 of cholesterol
  • Risk factors
  • Haemolysis
  • Liver cirrhosis
  • Biliary tract infections
  • Ileal resection
Cholesterol stones
  • Large
  • Often solitary
  • Yellow, white or green
  • Made primarily of cholesterol (gt70)
  • Risk factors
  • 4 F
  • Female
  • Forty
  • Fertile
  • Fat
  • Fair (5th F - more prevalent in Caucasians)
  • Family history (6th F)
Mixed stones
  • Multiple
  • Faceted
  • Consist of
  • Calcium salts
  • Pigment
  • Cholesterol (30 - 70)
  • 80 - associated with chronic cholecystitis
Complications of gallstones
  • In the GB
  • Biliary colic
  • Acute and chronic cholecystitis
  • Empyema
  • Mucocoele
  • Carcinoma
  • In the bile ducts
  • Obstructive jaundice
  • Pancreatitis
  • Cholangitis
  • In the gut
  • Gallstone ileus
  • Pain in the RUQ
  • Most common and typical symptom
  • May last for a few minutes to several hours
  • Mostly felt after eating a heavy and high-fat
  • Pain under right shoulder when lifting up arms
  • Fever, nausea and vomiting
  • Jaundice (obstruction of the bile duct passage)
  • Acute pancreatitis (gallstone enters the duct
    leading to pancreas and blocks it)
  • Ultrasound
  • Most sensitive and specific test for gallstones
  • Computerized tomography (CT) scan
  • May show gallstones or complications, such as
    infection and rupture of GB or bile ducts

Cholescintigraphy (HIDA scan) Used to diagnose
abnormal contraction of gallbladder or
obstruction of bile ducts
  • Endoscopic retrograde cholangiopancreatography
  • Used to locate and remove stones in bile ducts
  • Blood tests
  • Performed to look for signs of infection,
    obstruction, pancreatitis, or jaundice
  • Surgery Cholecystectomy (gallbladder removal)
  • 5 - 40 of patients develop postcholecystectomy
    syndrome (gastrointestinal distress and
    persistent pain in the RUQ)
  • 20 of patients develop chronic diarrhea
  • Two surgical options
  • Open cholecystectomy
  • Laparoscopic cholecystectomy
  • Nonsurgical treatment
  • Only in special situations
  • When a patient has a serious medical condition
    preventing surgery
  • Only for cholesterol stones
  • Oral dissolution therapy
  • Ursodeoxycholic acid - to dissolve cholesterol
  • Months or years of treatment may be necessary
    before all stones dissolve
  • Contact dissolution therapy
  • Eexperimental procedure
  • Iinvolves injecting a drug directly into the
    gallbladder to dissolve cholesterol stones
Contact Us
Dr. Satish Pattanshetti M.S ( Gen. Surg ) , F M A
S Fellowship in Bariatric and Metabolic Surgery
(Taiwan) Consulting Laparoscopic General
Surgeon Bariatric Metabolic Surgeon Specialist
in Single port Laparoscopic Surgery
Dr. Neeraj V Rayate Director and Principal
Surgeon Dr Neeraj Rayate is a GI and General
surgeon with expertise is laparoscopic and
robotic surgery for gastro-intestinal diseases
and bariatric surgery. After completing his
medical education in India. He has also completed
a fellowship in Gynecological Endoscopy from the
Giessen School of Endoscopic Surgery in Germany.
Dr. Rayate has special interest in
Hepatopancreatobiliary surgery and
gynecolological oncology.
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