Most common abdominal surgery is Gallbladder Surgery. Mostly it is done laparoscopically called as laparoscopic cholecystectomy. Most common indications is symptomatic gallbladder stone disease. The incidence of complications of laparoscopic cholecystectomy has decreased. Following are the complications of gallbladder surgery
It occur due to injury to blood vessels during gallbladder surgery. Whenever there is bleeding intra-operatively dont be panic.First step should be applying pressure at the bleeding site. Small venous injury stops after packing only. Field should be cleared and after proper visualization bleeding point should be identified and either cauterized or clipped should be applied. Do not hesitate to convert to open surgery if bleeding is not controlled laparoscopically
Bile duct Injury
The incidence of bile duct injury in gallbladder surgery has been decreased after the learning curve of laparoscopic surgery. It occur in difficult cases with dense adhesions at gallbladder fossa.In such cases it should be converted to open surgery. Dissection should be done close to the gallbladder.Intra-operatively whenever there is doubt of bile duct injury convert to open. If injury cannot be managed then put a drain and refer the patient to higher centre
Injury to Bowel, Rare Gallbladder Surgery Complication
Bowel gets adhered to gallbladder fossa due to recurrent inflammation. Pylorus and duodenum are most commonly injured organs. Hepatic flexure is another common site of injury. In post-op period if recovery is not smooth and Common Bile ductis normal a high suspicious of bowel injury should be suspected and CECT abdomen should be done
Dr Amit Jain MS MCh (GI Surgery) is best General & Gastrointestinal Surgeon in India Delhi Noida Ghaziabad NCR. He is fellow in Advance Laparoscopic Gastrointestinal Surgery
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The treatment of stomach cancer is successfull if diagnosed and treated at early stage. However more than 50% of stomach cancer when proceed for surgery are found to be metastatic. Most of the early stomach cancer symptoms or gastric cancer are non-specific and are overlooked. Chemotherapy is given by medical oncologist in advance cancer
Curative Surgical Treatment of Stomach Cancer
The standard curative treatment of stomach cancer is surgeryif patient if fit for surgery and cancer is resectable. Patients factors which are responsible for good recovery in the post-op period include nutrition and ambulatory level. Patient nutrition and chest functions are good recovery is easy. Staging laparoscopyis the first step in the surgery before definitive curative surgery is planned in case of open surgery. Staging laparoscopy helps in identification of metastases which are missed on CT Scan and PET Scan. No resection is done in case of metastatic disease unless tumor is bleeding. Radical gastrectomy is done. Depending on the location of tumor radical distal gastrectomy or radical sub-total gastrectomy or radical total gastrectomy is done. At least 12 lymph nodes should be dissected in the resected specimen for completeness of lymphadenectomy
Laproscopic Radical Gastrectomy
Radical gastrectomy can be done laparoscopically. Today we have enough evidence in the literature which support laparoscopic surgery in the abdominal malignancy. Laparoscopy surgery has the advantage of less pain and early recovery
Palliative Surgical Treatment of Stomach Cancer
If the stomach cancer is unresectable because either it is locally advance involving major blood vessels or it is metastatic then patient require some definitive therapy for palliation of there symptoms. If the tumor is bleedingand not controlled endoscopically or radiologically then palliative resection is done
Palliative Endoscopic Treatment of Stomach Cancer
If the stomach cancer is metastatic best method for palliation of symptoms is by means of endoscopy. The most common symptom that require palliation is vomitting, Endoscopically metallic stent is placed across the site of obstruction by Gastroenterologist
Consult Dr Amit Jain MCh (GI Surgery) Best Surgical Oncologist in Delhi Noida Ghaziabad India for Treatment of Stomach Cancer
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The recommended colon cancer treatment or intestinal cancer is surgery. Colon cancer is one of the gastrointestinal cancer in which surgery carries a very good prognosis. Patient should be fit for surgery and cancer should be resectable. Recent studies suggest that no bowel preparation is required before surgery.Patient should be on clear liquid diet one day prior to surgery
Colon Cancer Treatment: Curative
The standard surgical treatment of colon cancer is radical colectomy. Colon is divided into four parts, ascending or right colon, transverse colon, descending or left colon and sigmoid colon. Depending on location of cancer respective colectomy is done. After colonic resection depending on patient nutrition status and tumor burden either anastomosis is done or stoma is created. Minimal 12 lymph nodes is the criteria for adequate lymadenectomy for colon cancer has been recommended. If the number of lymph nodes resected is less than 12 then the patient need adjuvant chemotherapy irrespective of staging on histopathology report
Laparoscopic Colon Cancer Surgery
Colon cancers are being operated more frequently laparoscopically by Laparoscopic colo-rectal surgeon. The length of incision in laparoscopic surgery is very minimum as compared to open surgery. Minimal incision cause less pain in the post-op period, allow early mobilization of patient and early recovery
Colon Cancer Treatment: Palliative
Palliative surgery is done for multiple site metastatic disease.The two most common symptoms for which palliation is required is large bowel obstruction and bleeding. Right or ascending colon have a tendency to bleed. Left or descending colon because diameter is less compared to right colon causes obstruction. For patients who present with large bowel obstruction depending on tumor burden and patient nutrition status either bypass is done or stoma is created. For bleeding tumors resection is done and attendants are counselled for high risk surgery
Colon Cancer Treatment: Role of Chemo-Radiotherapy
Colon cancer are less sensitive to chemo-radiotherapy thats why its role is minimal in the management of colon cancer
Stomach cancer or gastric cancer is the fifth most common cancer worldwide but it is the third leading cause of cancer-related deaths. Most stomach cancer are diagnosed at advanced or metastatic stage as most patient do not seek medical advice at initial symptoms. Prognosis of any cancer is better if it is detected at early stage and treated.
Stomach Cancer Symptoms
Most common early symptoms are non-specific and includes dyspepsia, bloating,fullness, pain abdomen. Stomach cancer have a tendency for bleed, bleed is generally slow and patient passes black colored stool and develop anemia. Because of this slow bleed patient may have symptoms of anemia like tiredeness, weakness, Anorexia and weight loss are common as in other gastrointestinal cancer. When the cancer is located at antro-pyloric region it will cause vomitting. These symptoms and signs should not be ignored especially at old age
Stomach Cancer Diagnosis
When patient present with non-specific upper GI symptoms at old age associated with anorexia and weight loss first investigation to be done is upper GI endoscopy. It will detect any mass lesion or ulcer in the stomach. Biopsy should be taken from any suspicious lesion. Biopsyconfirms the diagnosis. Most common stomach cancer is adenocarcinoma
Once diagnosis is confirmed and patient is fit for surgery further investigations should be done for resectability of cancer, CECT abdomen is the ideal for staging the disease. It will detect distant metastases and relation of cancer to surrounding structures. PET scan should be done in patients who are high risk for surgery as it detect some occult metastases which are missed on CT Scan
Consult Dr Amit Jain MS MCh GISurgeon from GB Pant Hospital Delhi Senior Consultant Max Hospital Best Surgical Oncologist in Delhi
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The main stay of treatment of gallbladder cancer is surgery. In Northern part of India the incidence of gallbladder cancer is more as compared to southern part. Because of non-specific symptoms and signs of gallbladder cancer it is diagnosed at very late stage. Because of such high incidence of late diagnosis it carries a very bad prognosis
Curative Surgical Treatment of GallBladder Cancer
On Investigations when gallbladder cancer is found to be resectable and patient being fit for surgery, standard gallbladder cancer surgery is planned. Surgery for gallbladder cancer is radical cholecystectomy. In radical cholecystectomy gallbladder is removed along with the gallbladder liver wedge along with lymph nodes. Staging laparoscopy is the first step before opening the abdomen. The chances to identify metastases which are missed on CECT abdomenor PET scan is high in case of gallbladder cancer. If any suspicious lesion is identified on staging laparoscopy it is sent for frozen biopsy and if found to be mets then there is no need to proceed for defintive surgery and morbidity of long length incision is avoided
Palliative Surgical Treatment of Gallbladder Cancer
Gallbladder cancer can involve gastric antrum or duodenum and cause vomitting. In such cases palliative gastro-jejunostomy is done. It can also involve hepatic flexure of colon and cause large bowel obstruction. Some patient present in emergency with features of large bowel obstruction. In such cases either ileo-colic bypass is done or stoma is created depending on patient nutrition status.
Palliative Endoscopic Treatment of Gallbladder Cancer
The gallbladder cancer patients which are found to be metastatic before surgery and are locally advanced in which resection is not possible are candidates for endoscopic palliation of there symptoms. Most commonly these symptoms include jaundice and vomitting. Jaundice can be relieved by endoscopic biliary stent placement. If there is complete biliary obstruction then percutaneous transhepatic biliary drainage is done
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The most common indication for laparoscopic cholecystectomy is gallbladder stones disease or gallstone. Not all gallstones disease require surgery. It is only symptomatic one which require surgery. Gallstone disease may lead to biliary colic, acute cholecystitisor chronic cholecystitis. Porcelain gallbladder which is a risk factor for gallbladder canceris also an indication for laparoscopic cholecystectomy
As it is an elective procedure all routine lab investigations are done. Pt require Chest-X ray and ECG. Pre-Anesthetic check up is done. Patient require fasting for 6hr before surgery. Avoid hypogylcemic drug on day of surgery. Continue anti-hypertensive drug and thyroxine tablet on day of surgery with sips of water
Done mostly through four ports, but if there are no so much adhesions it can be done through four ports.Camera port is inserted. Under vision other ports are placed. Adhesionolysis is done if present. Cystic duct and artery dissected, clipped and divided.Gallbladder is dissected out. Gallbladder is extracted. Bileand stone spillage is avoided
Post-op Recovery after Laparoscopic cholecystectomy
Patient is allowed orally four hrs after surgery, starting from liquids and gradually increased to normal diet. Patient is encouraged to walk. It is day care surgery. If patient is comfortable can be discharged on same day of surgery otherwise next day. From next day onwards patient can do all his normal activities
Diet after Laparoscopic Cholecystectomy
Generally it is advised to avoid excessive fat in the dist for 2-3 months post surgery. After that patient can have normal diet
Dr Amit Jain MS MCh (GI Surgery) is Best Laparoscopic Surgeon in Noida. Take an appointment on 7351088686 to consult Dr Amit Jain. To know more on Gallbladder stone disease and its management visit our facebook page Dr Amit Jain Laparoscopic Gastrointestinal Cancer & Bariatric Surgeon
Gallstone disease is common and its incidence is more in female. The Treatment of choice for gallstone is surgery. The Standard Gallbladder Operation is called Laparoscopic Cholecystectomyin which whole of the gallbladder is removed. As mostly it is done laparoscopically it is called as laparoscopic cholecystectomy. There is no role of medications in the treatment of Gallbladder stones. The rate of complications due to gallstones does not depend on the number and size of stones
What causes Gallstones
There are various theories regarding the formation of Gallstone. There is no definitive preventive method.
The mainstay of gallstone diagnosis is Ultrasound Abdomen. It will detect the number and size of gallstones. Any associated stones in the Common Bile Duct. Thickening in the gallbladder wall. If there is any doubt of gallbladder cancer on ultrasound CECT abdomen should be done
Gallbladder Stone Treatment
The standard Gallbladder Stone Operation is surgical removal of the Gallbladder. Unlike kidney stones in which only stones are removed in case of gallstones, the gallbladder is removed. The gallbladder has no major function in our body. Gallbladder which is being removed is already diseased one and dose not effect our digestion
Lap cholecystectomy is the most common abdominal surgery. It is daycare surgery in which surgery is done in the early morning and the patient can be discharged by the evening. From next day onwards patient can do all his daily normal activities
Dr. Amit Jain MCh Gastrointestinal Surgeon at Max Hospital Patparganj Delhiand Vaishali Ghaziabad is a best laparoscopic surgeon in East Delhi for Gallstone surgery. He has been trained at GB Pant Hospital one of the best GI Surgery Institute in India. He has performed various complex GI Surgery in the last 15 years. He is fellow in Advance Laparoscopic Surgery
Gallbladder stone disease is common.Ultrasound abdomen is the commonest investigation for any abdomen complaint. The result being the incidence of asymptomatic gallstones is also increasing. Incidence of Gallbladder stones is more in females. There are various theories about formation of gallbladder stones.
Gallbladder Stone Complications
It is said that in 90% of patients the first complaint of Gallstones is right upper abdomen pain. After the first episode the frequency of pain abdomen increases and so the complication rate. In 10% of patients, the first presentation can be one of the complications of Gallbladder Stone. The complications of gallbladder stone include Jaundice/Cholangitis/pancreatitis/Cancer Gallbladder/fistulous communication to nearby organs, when the stone in the gallbladder pass to common bile duct through cystic duct patient can have just jaundice if it simply obstruct the CBD lumen and prevent passage of bile from CBD to duodenum. This obstruction when leads to infection patient will have fever and it is called as cholangitis. Cholangitis is a serious condition and patient may develop septic shock and require urgent biliary drainage.
It is another life threatening complication. Passage of stone lower down causes temporary blockage of pancreatic secretions and can cause. biliary pancreatitis.
Long-standing inflammation anywhere in the body predispose to cancer so in case of Gallbladder Stone. Gallbladder stone is known risk factor for Gallbladder Cancer. Incidence of cancer is very minimal. This is not an indication for surgery in asymptomatic gallstone patients.
The standard treatment is Laparoscopic Cholecystectomy. Advantage of laparoscopic surgery is less pain and early discharge. It is day care surgery in which patient can be discharged on same day of surgery
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Dr. Amit jain is best Gastrosurgeon in Noida, Ghaziabad, Indrapuram, Delhi NCR India for Gallbladder Stone Surgery.
Gallbladder Cancer incidence is more in Northern part of India. It is important to know gallbladder cancer symptoms. If we know these symptoms we may consult to doctor early and have early diagnosis. Early diagnosis and treatment is key for long term survival rate in gallbladder cancer patients.
Gallbladder Cancer Symptoms
The most common Gallbladder cancer symptom is pain localized to right upper abdomen. Anorexia and weight loss are common symptoms as seen in other cancer. Gallbladder cancer patients can present with gastric outlet obstructionsymptom that is vomiting. It occur when gallbladder cancer involve gastric antrum or pylorus or duodenum. When cancer involve hilum it can cause biliary obstruction leading to jaundice. This jaundice is called as surgical obstructive jaundice. Its feature are generally it is painless, dark colored urine and pale colored stools. Gallbladder cancer can involve hepatic flexure of colon. When it involve colon patient present with feature of large bowel obstruction like abdomen distension, non-passage of flatus and motion. Metastatic gallbladder cancer present with abdomen distension in the form of ascites.
Gallbladder Cancer Diagnosis
When patient present with gallbladder cancer symptoms first line of investigation is USG whole abdomen. It will detect any mass in the gallbladder or any focal thickening. CECT abdomen is done for local tumor invasion and distant metastases.
The standard treatment is surgery if tumor is resectable. Surgery done is radical cholecystectomy in which Gallbladder is removed along with Liver wedge and lyphadenectomy is done.
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Consult Dr. Amit Jain Best GI Oncologist in East Delhi Noida for any query regarding Gallbladder Cancer. It is important to remember that Gallbladder Cancerprognosis is good if detected early.Do not ignore above mentioned symptoms. Make an appointment for Dr Amit Jain at 7351088686 to know about Gallbladder Cancer Symptoms and Gallbladder Cancer Treatment.
Today is era of Laparoscopic Surgery.Laparoscopic Colorectal Surgery has evolved gradually and nowadays even Colorectal Cancer surgery are also being done Laparoscopically.
Laparoscopic ColoRectal Surgery for Benign ColoRectal Disease
There are various benign colorectal diseases which are being done Laparoscopically. Common disease include Appendectomy, Right Hemicolectomyfor ileo-cecal tuberculosis, Sigmoidectomy for sigmoid diverticular disease, Total abdominal colectomy for Ulcerative Colitis. In Ulcerative colitispatients even pouch procedure is done laparoscopically
Laparoscopic ColoRectal Surgery for ColoRectal Cancer
Malignancy can involve any part of colon and rectum. Depending on the site of cancer various colectomy are done. These are called as radical colectomy as lymphadenectomy is also done. For rectal cancer anterior resectionis done. Depending on the location of tumor in the rectum either low anterior resection or ultra-low resection is done. Initially there was concern of long term survival rate in colorectal cancer patients being operated Laparoscopically. But now we have enough data which says that there is no difference in recurrence rate and survival rate patients being operated open or laparoscopic approach.It is the reason that colorectal malignancy patients are being operated more commonly laparoscopically by colorectal surgeon who are trained in laparoscopic surgery
Emergency Laparoscopic ColoRectal Surgery
It Include surgery for large bowel perforation, traumatic large bowel injury and large bowel obstruction.
Advantages of Laparoscopy ColoRectal surgery is early recovery.Patient can be discharged early from the hospital.No prolonged rest is required.
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Dr Amit Jain is Best ColoRectal Surgeon in Noida. Trained in GI Surgery at GB Pant Hospital Delhi. Special training in advance laparoscopic GI Cancer Surgery. Got Fellowship in Advance Laparoscopic ColoRectal Surgery. He is working at Max Hospital Patparganj Delhi and Vaishali Ghaziabad as Senior Consultant Dept of GI Surgery