No two patients have similar gall-stones, they differ in numbers, size, shape, color, consistency, chemical composition, site etc. This do matter a lot in cases of minimal access surgery. For example stone is solitary and you have removed it then no further wasting of time to search other stones, second example if stone or stones are 1 cm and cystic duct is 3 mm then there will be no chance of stone to go into CBD, vise versa stones are 2mm then chances are they may go to CBD.

A few examples

Gall-stones are the most common biliary pathology, mostly are asymptomatic and one of commonest operation is cholecystectomy due to them.

Cause abnormal emptying of gallbladder, bile stasis and bile infection.

Types cholesterol pigmented and mixed.

Clinical presentation mostly asymptomatic and incidentally discovered on imaging, (ultrasound, X-rays, etc.). Common presentation is pain in RHC or epigastrium may radiate to back with nausea and vomiting, other symptoms are dyspepsia, flatulence, food intolerance and some time jaundice when stone obstruct the common bile duct.

Diagnosis after history and clinical examination investigations like ultrasound and radiological imagine (MRCP, CT scan) will finalized. Positive Murphy’s sign have significance, mass may be palpable in RHC. In diabetic patient perforation of gallbladder may be earlier present with localized or generalized peritonitis.

Treatment: Gall-stones should not be in the gallbladder, cystic duct or common bile duct, so cholecystectomy is treatment of choice whether condition is acute or chronic.

Furthers examples of stones

Leave a Reply