Urgent surgery for a seizure
With persistent pain, temperature and ultrasound signs of destruction (thickening of the wall, fluid around the bladder), waiting is dangerous due to gangrene and peritonitis - early surgery is safer than delayed surgery. The tense bladder is preliminarily punctured and emptied, the inflamed adhesions are separated, the bladder is removed with mandatory drainage of the subhepatic space for 1–2 days; antibiotics are prescribed. Conversion to open access for gangrene and dense infiltrate is not a complication, but a safety measure (less than 5% of cases). Discharge is usually 2–3 days after removal of the drainage.
Indications
- cholelithiasis with attacks of biliary colic - planned removal;
- acute cholecystitis (phlegmonous, gangrenous) - urgent surgery;
- chronic calculous cholecystitis, “porcelain” bladder, polyps more than 10 mm;
- asymptomatic stones in diabetic and pre-bariatric patients (if indicated);
- condition after choledocholithiasis and pancreatitis caused by stones.
Why is the entire bubble removed?
It is impossible to remove “only stones”: the changed bladder forms them again within 1–2 years, so the world standard is cholecystectomy. After surgery, bile enters the intestines directly; digestion in the vast majority of patients completely adapts within a few weeks while following a diet in the first 1–2 months. Postponing planned surgery during repeated attacks is dangerous: each new episode threatens acute cholecystitis, pancreatitis and migration of stones into the duct, which complicates treatment.
Benefits of laparoscopy
Laparoscopic access is the standard of modern abdominal surgery: instead of a 10–20 cm incision, 3–4 punctures are left, the pain after surgery is much less, the patient gets up on the day of surgery and is discharged after 1–2 days, the risk of wound infection, hernias in the scar and adhesions is several times lower, and the enlargement of the camera allows you to operate more accurately. In the clinics below, operations are performed by surgeons with extensive laparoscopic experience; hospital (SKD) is included in the price according to the price list.
