1. Ouch! I Think My Gall Bladder Hurts! Jody C. DiGiacomo, M.D., FACS Department of Surgery CentraState Medical Center

2. What Is The Gall Bladder? A Bag Shaped Organ Under the Liver That Holds, Concentrates and Stores Bile

3. Biliary System Bile is Made by the Liver Flows Into Small Channels Converge Into Large Ducts Stored in Gall Bladder Moves Into Intestine When Needed

4. What Is Bile? Dark Green and Bitter Tasting Functions: Aid Digestion of Fats Help Neutralize Stomach Acid Excretion of Complex Wastes Composition: 85% Water 10% Bile Salts 3% Pigments 1% Inorganic Salts & Cholesterol

5. What Are Gall Stones? Result of An Imbalance Between the Components of Bile Age Ethnicity Diet Medical Conditions

6. What Is Biliary Colic? Right Upper Quadrant Pain Epigastric Pain May Be Severe Nausea, Vomiting Lasts > 1 Hour and < 24 Hours

7. Anatomy

10. Symptomatic Cholelithiasis 67% of Patients With Gall Stones Remain Asymptomatic 70% Will Have Recurrent Episodes 6-8% Will Need Surgery Each Year

11. Diagnosis History and Clinical Exam Abdominal X-Rays Ultrasound CT Scan HIDA Scan

12. Treatment Options Cholecystectomy The Surgical Removal of the Gall Bladder Stone Removal Does Not Cure Condition

13. Laparoscopic Cholecystectomy Under General Anesthesia Tubes Placed Thru the Abdominal Wall The Abdomen Is Filled With Air Long Instruments Are Used To Remove the Gall Bladder From the Liver Removed From The Abdomen Via the Umbilicus

14. Laparoscopic Cholecystectomy

21. If The Gall Bladder Can Not Be Safely Removed Laparoscopically, The Abdomen Must Be Opened In The Traditional Manner

22. Open Cholecystectomy

26. Laparoscopic Vs Open Less Post Operative Pain Faster Recovery Faster Return to Life Less Pain Medications

27. Biliary Pain After Surgery Abdominal Pain and Other Symptoms May Persist or Recur In up to 20%

28. Diet After Surgery No Specific Restrictions Individualized Intolerences

29. Gall Stones A Common Finding In Many Symptomatic in Few Surgery Warranted for Symptoms

30. Laparoscopic Cholecystectomy Few Contra-Indications Same Day Surgery or Overnight General Anesthesia 1-2% Require Conversion To Open

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