Acency Title: Barifa Sağlık ve Turizm Travel Agency
The gallbladder is an organ where bile, which is synthesized and secreted in the liver, is stored and concentrated before flowing into the duodenum during fasting. The bile stored in the gallbladder is first transferred to the main bile duct and then to the duodenum as a result of the contraction of the gallbladder when needed. Bile; It plays an important role in the digestion and absorption of fats and fat-soluble vitamins taken with meals, it plays a role in the regulation of cholesterol level in the body by the excretion of cholesterol into bile fluid, and also ensures the excretion of the golden yellow substance called bilirubin, which is formed as a result of blood breakdown, from the body. An adult person synthesizes an average of 400-800 cc of bile per day.
In the gallbladder, sometimes gallstones can occur depending on the characteristics of bile and the state of bile flow . These stones may irritate the gallbladder wall over time and cause gall bladder inflammation characterized by abdominal pain, nausea, vomiting and fever . In addition, gallstones, especially small ones, may fall into the main bile duct and cause a decrease or pause in the flow of bile to the intestine. In this case, yellowing of skin and eyes in white, itching, darkening of urine, stool color, characterized by the opening of obstructive jaundice occurs statement. Some of the rare pathologies that may occur in the gallbladder are gallbladder polyps andgallbladder cancers are Gall Bladder Surgery
When one of the gall bladder diseases mentioned above occurs, surgical treatment comes to the fore.
Gallstones do not always show signs and symptoms and can be diagnosed incidentally during abdominal ultrasonography performed for another reason. Regardless of whether they cause symptoms or signs, gallstones should be treated surgically from the moment they are recognized. This is because gallstones have the potential to cause gallbladder inflammation and obstructive jaundice at any time.
Surgery in gallbladder inflammation should be planned as much as possible in the period after the inflammation is controlled. If the inflammation cannot be controlled, surgical treatment may be considered under emergency conditions.
Surgical treatment in gallbladder polyps is planned depending on the size and number of the polyp. Single polyps larger than 1 cm should be treated surgically due to the high risk of cancer development there. Polyps with a single size and between 0.5-1 cm can be monitored or treated by surgery according to many variables such as the surgeon’s experience, the general health status of the patient, whether the patient can come for regular check-ups. Single and less than 0.5 cm polyps should be followed if there is no clinical and laboratory data in favor of cancer. Multiple polyps should be surgically treated regardless of their size.
Surgical treatment planning should be done without delay in gallbladder cancer .
Regardless of the pathology in gallbladder surgery, the entire gallbladder is removed and removed during surgery. Applications such as removing only the stone from the gallbladder or partial gallbladder removal are not performed by surgery. In addition, there is no treatment method for gallstones, such as kidney stones, with stone breakage. The reason for this is that broken and shattered stones can fall from the gallbladder to the main bile duct and cause obstructive jaundice .
A sine qua non of a safe surgery is a thorough and thorough patient evaluation before surgery.
For this purpose, the first thing to be planned is a detailed patient-doctor interview. After this interview, your doctor;
You have reached your physical data (height, weight, BMI etc.),
Learned what your expectations are from the surgery,
You learned the physical damage caused by gallbladder complaints,
You have mastered what other diseases you have besides gall bladder disease
You have decided whether you can follow some rules and lifestyle changes that you will be asked to follow after the surgery,
You will be able to make a comment about your general health status.
The next step is to make a detailed pre-operative evaluation in the hospital. At this stage;
Detailed blood tests,
Abdominal ultrasonography,
Stomach endoscopy (if needed)
Lung X-ray,
Respiratory function tests (if needed),
Doppler ultrasonography of your veins in case of doubt,
ECG, Echo cardiography tests (in case of need),
Cardiologist examination (in case of need),
Internal medicine specialist examination,
By making an anesthesiologist evaluation, it is evaluated whether you are suitable for a safe operation.
Thanks to today’s modern surgical methods, these operations are now routinely performed by laparoscopic surgery. In laparoscopic surgery, your abdomen is not opened to reach the operating area. With the CO2 gas given into your abdomen, your abdomen is inflated and 4-6 tubes of different diameters (5mm-10mm-12mm and 15mm, depending on the shape of the surgery and the surgeon’s preference) are placed in your abdominal wall, and the organs where the operation will be performed are reached with surgical instruments. your surgery is performed.
Although laparoscopy is the most commonly used method as a routine procedure today, robotic surgery is also an alternative surgical method.
Rarely, these operations can be performed with open surgery. Open surgery is a method that can be applied after any problems that may arise during laparoscopy or robotic surgery. It should not be forgotten that every closed method (Laparoscopic or Robotic) has the potential to switch to open surgery to a certain extent.
Since your surgery is a surgical procedure to be performed on the digestive system;
In general, it is beneficial to start consuming watery food 1 day before the surgery, to have your bowels empty during the surgery and to make your toilet need later and easier afterwards.
If you are using blood thinners, you should definitely warn your doctor about this and give your doctor time to stop these drugs and start alternative drugs.
It is okay to use drugs other than blood thinners that you have to use routinely until the night of the surgery. Blood pressure medication, heart medication can be drunk with a little water on the morning of the surgery, within the knowledge of your doctor, at least 2 hours before the operation.
If you smoke, it is necessary to quit smoking at least 1 week before the surgery or to reduce it to the minimum possible level. This is a situation that will directly affect your postoperative lung performance.
One night before the surgery, you should generally stop all solid or liquid food intake at around 22-23 o’clock, and be ready with at least 6 hours of fasting the morning of the surgery.
Take a bath at home before you go to the hospital before the operation. Do not forget that you will not have a bath for at least 2 or 3 days.
Do not wear nylon-containing underwear while coming to the hospital. Nylon underwear can interact with some electrical devices used during surgery and cause skin burns.
When you come to the hospital, it is useful to bring slippers, personal cleaning equipment (toothbrush, toothpaste, shaving kit, etc.) and sufficient underwear.
Although your hospital stay is affected by many factors such as whether you are in the hospital the night before or on the morning of the surgery, how long your surgeon takes the principle of keeping the patient in the hospital after surgery, whether your surgical problem develops after surgery, it is usually up to 1-2 nights.
If you have been hospitalized the night before the surgery, you should use protective blood thinners in your home if you are going to bed in the morning of the surgery. This treatment will be planned and applied by your doctor. Before you go to the operating room on the morning of the surgery, you should definitely go to the toilet and meet your needs. The time between being taken from your bed for surgery and returning back to your bed will vary depending on the surgery to be performed, but usually will be 2-3 hours. All of this time is not the time taken for the operation, the preparation period in the operating room, your surgery and your post-surgery wake up process are in this process. Mostly, you will be taken to your bed on the floor after surgery, there is usually no need for postoperative intensive care. In the days after the surgery, the process takes place as follows;
On the day of surgery: Approximately 4-5 hours after returning to your bed, you lift you for the first walk and take a small walk in the room. On the day of the surgery, all your treatments are performed intravenously and food intake is not allowed.
The 1st day after the operation: Today is the day you start drinking sips of water, smooth soups and fruit juices. We also increase the amount of walking during the day and enable you to have a more active day. If you do not have any surgical problems at the end of today and your surgery was performed laparoscopically, your discharge can be planned according to your surgeon’s preference.
2nd day after surgery: If you are not discharged on the 1st day after the operation, you will be asked to increase your food intake at a certain interval in terms of amount and variety and spend the day more active. If you are thought to have no surgical problems at the end of the day, you will usually be discharged from the hospital towards the end of today.
Your time to return to normal life is highly related to your job. If you are doing a desk job, you will be able to do your job for a short time in 2-3 days after you are discharged from the hospital. But the standard rest period is 7 days for this work group. If you are working in a job where you need to work physically, you can rest for a period of 10-12 days and then be at your job.
After you are discharged from the hospital, you will be advised to follow a diet program that can be called gallbladder diet for a certain period of time, and then switch to normal nutrition. The content and duration of this diet, which will be planned after the surgery, will be explained to you in detail by our dietitians. In non-cancer gallbladder surgeries, you do not need to have periodic control examination unless you have complaints after surgery.
