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Gallbladder Disease

What is Gallbladder Disease?

Located under the liver, the gallbladder is a sac which stores bile that is made in the liver. Bile is produced by the liver to help in the digestion of fats. It is released from the gallbladder into the upper small intestine after eating a meal for this purpose.

The most common gallbladder diseases that occur in patients are inflammation (cholecystitis), gallstones (cholelithiasis or cholecystolithiasis), or abnormal gallbladder contraction (biliary dyskinesia). In the case of cholelithiasis, stones can block the ducts that lead from the gallbladder causing severe pain and nausea, and even fever and severe illness.

Cause

Gallstones form when bile coalesces or develops into hard particles. They can be as small as a grain of sand or as large as a golf ball. Typically women are at higher risk than men, particularly those that are over 40 years of age and overweight.

A "gallbladder attack" is caused by severe inflammation of and around the gallbladder. This usually happens because a stone is blocking the major duct draining the gallbladder. This results in severe pain in the upper-right side of the abdomen, often accompanied by nausea and vomiting. Symptoms of gallbladder disease include:

  • Pain generally on the right side of the abdomen, which may radiate to the back
  • Abdominal pain following a meal
  • Intolerance for fatty foods
  • Nausea, vomiting, loss of appetite
  • Bloating, gas, and painful digestion

Medical Treatment

Generally, there is no medical therapy for gallbladder disease. While some drugs can dissolve stones, their role in treating gallbladder disease is very limited.

  • An oral bile acid, ursodeoxycholic acid, can dissolve cholesterol stones that are quite small (less than 15 mm in diameter). The drug is successful in about 40% of patients.
  • Methyl tert-butyl ether and monooctanoin are solvents that are infused directly into the bile duct or the gallblad­der to dissolve stones.
  • Shock wave therapy (lithotripsy) to break up stones.

continued on back

Definitive/Surgical Treatment:

Cholecystectomy is the surgical procedure to definitively treat gallbladder disease.

Approach:

Laparo-Endoscopic Single Site (LESS) Surgery:

This minimally invasive procedure allows for a smaller incision and a shorter hospital stay than traditional "conventional" surgery. LESS cholecystectomy involves the same surgical plan, in general, as conventional laparoscopic cholecystectomy, but with only one incision at the belly-button. When the operation is over, there is only one scar, and it is hidden in the umbilicus (i.e., the belly button). Thereby, there is no scar since the operation is "hidden" in the umbilicus. LESS surgery promises improved cosmesis, quick recovery, reduced pain, and shorter length of hospital stay. Most of all, after LESS cholecystectomy, there is "no scar".

Since April 2008, we have undertaken over 500 Laparo-Endoscopic Single Site (LESS) cholecystectomies. We pioneered the LESS surgery approach for cholecystectomy and have presented and written on this approach and on gallbladder disease widely. We published and given presentations on LESS cholecystectomy at regional, national, and international meetings.

The LESS surgical approach is a safe and cosmetically superior option for patients requiring gallbladder removal. Our extensive cumulative experience utilizing this approach has allowed us to begin undertaking LESS cholecystectomy without general anesthesia.

LESS Cholecystectomy with Epidural Anesthesia:

Since the operation is so minimally invasive we do have options in regards to the type of anesthesia available to be administered. Patients have the option for this procedure to be undertaken with epidural anesthesia. If they want they could watch the operation as it is occurring. This also eliminates the risk associated with general anesthesia.

Robotic Cholecystectomy:

With the advent of Robotic surgery, as accomplished and certified Robotic surgeons, you also have the option to have your gallbladder removal undertaken with this approach.

What to expect after an operation for your gallbladder:

Some patients but not all experience one or more of the listed symptoms below:

  1. Shoulder pain lasting from 1-3 days after surgery. The pain is related to CO2 insufflation necessary for minimally invasive surgery. The CO2 irritates the diaphragm which in turn sends referred pain to the shoulders. The shoulders are not injured. The more active you are after surgery (i.e. walking and staying out of bed) the quicker the pain will resolve.
  2. Nausea and/or vomiting may occur after surgery for 1-2 days. This is usually related to general anesthesia administered during the operation.
  3. Discomfort at the belly button for 1-7 days. We use the belly button to access the surgical site with very small instruments and a scope. Some level of discomfort is normal. If, however, you notice the belly button to have redness, is hot to the touch, has discharge, increased pain, and/or fever, please call my office or come to our emergency room.
  4. Discomfort in the right upper quadrant for 1-7 days. This is the location of the actual operation inside your abdomen. It is normal to feel discomfort for several days.

Dr. Sharona Ross and Dr. Alexander Rosemurgy

If you or a loved one has been diagnosed with gallbladder disease and need surgery as a treatment for the disease, we urge you to consult with us at our office at your earliest opportunity. We serve patients in the greater Tampa area as well as those throughout the state of Florida. Dr. Sharona Ross and Dr. Alexander Rosemurgy and their surgical team are experienced in performing advanced upper GI, pancreatic, gall bladder and liver surgeries.


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Sharona Ross, M.D. - Tampa Laparoscopic Surgeon
Located at 3000 Medical Park Dr, Suite 500 Tampa, FL 33613. View Map
Phone: (813) 615-7030
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