Gallstone disease: causes and manifestations
This is just one more way of ensuring your safety and that of our staff. Read more. This information will help you learn how to prepare for bile duct tumor surgery at Memorial Sloan Kettering MSK and help you understand what to expect during your recovery. Bile is a substance that helps the body digest food.
It is produced in the liver and passes through the bile ducts. The bile ducts have many small branches that spread throughout the liver, like the branches of a tree. When they unite, they form the common bile duct, see Bile passes through the bile ducts from the liver and gallbladder to the first section of the small intestine, the duodenum.
If a tumor blocks the bile duct, bile does not flow into the small intestine. Instead, it is absorbed into the bloodstream. Symptoms of a blocked bile duct include yellow skin, jaundice, itching, discolored stools, and dark tea-colored urine.
The tumor may be located in the upper part of the bile duct closer to the liver, in its middle part or in the lower part of the bile duct closer to the duodenum and pancreas, see Figure 2. Possible location of bile duct tumors. The type of surgery to be performed depends on the size and location of the tumor in the bile duct.
It will be determined by the surgeon before the operation. There are several types of operations to remove tumors in the bile ducts.
On average they last 3-5 hours. To remove the entire tumor, the common bile duct and gallbladder are removed. Your body will function normally without the gallbladder. During this operation, the surgeon will connect the small intestine to the remaining part of the bile duct. This will help move bile from the liver directly into the small intestine. In some cases, the tumor affects the liver. If so, the surgeon will remove part of the liver. The surgeon will connect the small intestine to the rest of the bile duct.
The surgeon may also have to remove parts of the liver, pancreas, gallbladder and small intestine. To remove the entire tumor, the surgeon will have to remove the head of the pancreas, duodenum, end of the common bile duct, and gallbladder. A small part of the stomach may also be removed. If the tumor cannot be removed, the surgeon will connect the small intestine directly to the bile duct.
This will help remove bile from the liver directly into the small intestine, bypassing the tumor. You will be prescribed presurgical testing PST. The date, time, and location of your preoperative test will be indicated on the reminder you receive from your surgeon's office. On the day of your preoperative test, you can take food and medications as usual.
You will need a number of tests, including an electrocardiogram EKG to check your heart rhythm, a chest x-ray, blood tests, and other tests needed to plan your treatment. These resources provide more detailed information about how to prepare for surgery. Hibiclens is a skin cleanser that kills infectious agents and prevents their reappearance within 24 hours after use.
By showering with Hibiclens before surgery, you will reduce the risk of infection after surgery. You can purchase Hibiclens at your local pharmacy without a prescription. You will need the following:. You will be required to follow a zero healing diet the day before surgery. Examples of clear liquids are shown in the table below.
While following this diet:. During bowel preparation:. Once MiraLAX has dissolved, you can place the mixture in the refrigerator if desired. MiraLAX will cause frequent bowel movements, so stay near the toilet the night before your surgery or procedure. On the day before surgery, take 1 bisacodyl tablet with a glass of water. On the day before your surgery, start drinking MiraLAX Colon Cleanse.
Drink 1 8-ounce [mL] glass of solution every 15 minutes until it runs out. When you finish drinking MiraLAX, drink a glass of clear liquid.
You can continue drinking clear liquids until midnight, but this is not necessary. This will prevent irritation. The Admitting Office will call you the day before your surgery. You will be told what time you should arrive for your surgery. If your surgery is scheduled for Monday, you will be called on Friday. If no one contacts you before, call the number. The evening before the operation, take a shower with Hibiclens. To use Hibiclens, open the bottle and pour a small amount of solution into your hand or onto a terry cloth.
Move away from the stream of water to avoid washing off Hibiclens immediately after application. Gently rub it into your body from neck to waist and rinse. Do not allow the solution to come into contact with your eyes, ears, mouth or genital area.
Do not use any other soap. After showering, dry off with a clean towel. Shower with Hibiclens before going to the hospital. Use Hibiclens in the same way as the night before. Do not apply any lotion, cream, powder, deodorant, makeup or perfume after showering.
To enter the garage, turn onto East 66th Street from York Avenue. The garage is located approximately a quarter block from York Avenue, on the right north side of the street. A pedestrian tunnel leads from the garage to the hospital. You can find out about parking prices by calling your phone number. You will need to spell and spell your first and last name several times, as well as your date of birth. This is necessary for your safety. Surgery may be scheduled for several people with the same or similar names on the same day.
Before the operation begins, your visitors will be escorted to a waiting area. You will go to the operating room on your own, or you may be wheeled there on a gurney. A member of the operating room team will help you onto the operating table.
Special compression boots will be placed on the lower part of your legs. They will gently inflate or deflate to improve blood circulation in the legs. Your anesthesiologist will place an intravenous IV in one of the veins, usually in your arm or hand.
An IV will be used to administer fluids and anesthetic medication to keep you asleep during surgery. Once you fall asleep, a breathing tube will be inserted through your mouth into your windpipe to help you breathe. In most cases, patients remain in the recovery room overnight for observation. After your stay in the recovery room, you will be transferred to a hospital room on the inpatient unit. Below are some tips to help make this process safer.
After surgery, you may experience pain in the area of the incisions. Pain relief is essential so that you can clear your throat, breathe deeply, use your incentive spirometer, and get out of bed and walk. You will not be able to eat for one to two days after surgery. You will then need to follow a zero healing diet. After this, you will gradually return to your normal diet.
Many people lose weight before surgery. As your appetite improves, you will gradually regain your previous weight. You may also gain weight immediately after surgery as your body retains water over the next few days. It is very common for patients to feel weak, unusually tired, or fatigued for 6 to 8 weeks after surgery. Some of this weakness is due to the surgery you had and also because you may have lost weight before surgery.
Over time, this symptom will gradually weaken. Try to increase your activity level daily, this will help overcome weakness. Get out of bed, get dressed and walk.
Gradually increase the distance you walk daily. If necessary, you can sleep during the day. However, try to stay awake as much as possible so that you can sleep at night.
Treatment
The doctor develops treatment tactics based on diagnostic data and the nature of the pathology. The appearance of sediment is only a consequence and its elimination will undoubtedly alleviate the patient’s condition, but will not get rid of the cause.
However, if an ultrasound examination revealed an echogenic fine suspension that settled when sand came out of the kidneys or after crushing stones, then it is enough to follow a plentiful drinking regime and a special diet to facilitate the removal of particles. If you want to learn about the symptoms and folk remedies treatment of sand in the bladder in women and men, go here.
Basic principles of treatment:
- Relief of pain;
- Relief from difficulties when emptying the bladder;
- Reducing the salt content in urine and removing sand and stones (if any);
- Strengthening immune defense;
- Treatment of primary pathology: inflammatory process, bladder dysfunction.
Drug therapy
In most cases, the suspension is formed against the background of various inflammatory processes.
The standard therapeutic regimen includes:
- Prescription of antibiotics - Monural, Nitroxoline, Norfloxacin, Furazidin, Cefixime, Palin in order to suppress inflammation, destroy harmful microflora and restore normal functioning of the organ. You can quickly relieve inflammation with the help of installations of sea buckthorn oil and Miramistin into urine.
- To relieve pain, No-Shpa, Drotaverin, Baralgin, Spazmalgon are indicated. Clinicians also recommend the use of suppositories such as Voltaren.
- In order to normalize the outflow of urine and empty the bladder cavity, therapy with plant-based uroseptics is prescribed: Canephron, Cyston, Urolesan, Fitolysin, Uronefron. It is recommended to combine the use of medications with the use of decoctions of horsetail, chamomile or dill seeds, as well as lingonberry and cranberry juices. If a bladder infection is detected in women, douching with infusions of horsetail and chamomile is additionally prescribed.
- If urinary incontinence occurs , then taking Detrusitol is indicated.
- To stimulate the immune system, you can take Uro-Vaxom.
This regimen is applicable for the treatment of MP; for pyelonephritis, the therapy will be different.
Drinking regime and nutrition
The success of treating such pathologies directly depends on adherence to proper drinking and nutrition.
- Drink more fluid, then the urine will be less concentrated and suspended particles will be more easily washed out of the bladder. You can drink water, weak teas, dried fruit compotes, fruit drinks, but you will have to forget about coffee and alcohol.
- Do not over-salt your food - daily salt intake should not exceed the age norm.
- All winter preparations: pickles and marinades, as well as smoked meats, spicy and canned foods and dishes will have to be excluded from the diet.
- Those with a sweet tooth should avoid sweets of any kind, as they contain a large amount of salts.
HISTORY OF THE STUDY OF GALL BLADDER AGENESIS: 1701–1970
Stones can form in various organs, but most often occur in the liver, gallbladder and kidneys. Why do stones originate in a particular organ? There are many reasons - nutritional disorders, improper metabolism, and malfunctions of the endocrine glands. How stones are detected, what methods can be used to get rid of them, what are the symptoms of diseases - all this is described in detail in this book. It provides proven recommendations on diets and herbal medicine. The book is addressed to a wide range of readers - regardless of gender, age, social status. The given introductory fragment of the book The most important thing about kidney stones, bladder stones, cholelithiasis by A. Vasiliev, provided by our book partner - the liters company. We will move downward, since the direction of reasoning here is not so important.
Bile, which is produced in the liver, enters the gallbladder and bile ducts through the hepatic duct.
