PROCEDURES
Biliary Surgery
Biliary surgery targets the bile duct, a tube that transports digestive juice to dissolve lipids. A gallstone or tumour can obstruct the flow of bile. Obstruction of the bile duct causes jaundice, nausea, and stomach pain, which may be complicated by fever, bleeding tendencies and itching.
Gallstones comprise of cholesterol, bilirubin and calcium salts. When there’s too much cholesterol in bile, yellow gallstones form. When the spleen terminates old red blood cells, there’s the release of a chemical known as bilirubin. Any combination of abnormalities or increased concentration of these substances can lead to stone formation. These stones mostly form within the gallbladder where bile is temporarily stored.
PROCEDURES
Biliary surgery
Biliary Surgery targets the bile duct, a tube that transports digestive juice to dissolve lipids. A gallstone or tumour can obstruct the flow of bile. Obstruction of the bile duct causes jaundice, nausea, and stomach pain, which may be complicated by fever, bleeding tendencies and itching.
Gallstones comprise of cholesterol, bilirubin and calcium salts. When there’s too much cholesterol in bile, yellow gallstones form. When the spleen terminates old red blood cells, there’s the release of a chemical known as bilirubin. Any combination of abnormalities or increased concentration of these substances can lead to stone formation. These stones mostly form within the gallbladder where bile is temporarily stored.
Many complications can arise when a gallstone blocks the gallbladder or the bile duct. One of these complications is inflammation of the gallbladder, also known as acute cholecystitis. When the stone blocks the bile duct, it can cause jaundice and infection of the bile. This condition is called cholangitis and may become life-threatening. Cholangitis is one of the emergencies that is treated with antibiotics and an ERCP procedure. Also, small stones may pass through the bile duct into the intestine spontaneously. These small stones can cause a condition called Biliary pancreatitis.
Most of these complications have similar symptoms. These symptoms are a mixture of jaundice, pain in the upper abdomen, which could feel like stomach pain, nausea, vomiting and fever.
BILIARY SURGERIES
Types of biliary procedures are:
- Bile duct exploration: Bile duct exploration is an operation of the bile duct to remove stones stuck in the bile duct that could not be removed via ERCP for whichever specific reason. It can also be done when there has been an injury to the bile duct. It is performed under anaesthesia. Dr Pretorius makes an incision on the abdomen, finds the bile duct and opens the duct. If an injury is to be repaired, this is done by the appropriate manner for the injury. If stones are stuck, they are removed with a special forceps. A special camera, called a cholangioscope, is placed up and down this duct to ensure it is cleared of stones before the opening is repaired or reconstructed.
- Cholecystectomy: Cholecystectomy is a procedure to remove the gallbladder. This procedure prevents the recurrence of gallstones, treats infection and relieves pain. Dr Pretorius performs minimally invasive cholecystectomy and inserts tiny tools through small incisions to remove the gallbladder. Open surgery is an alternative option. Open surgery, however, entails a longer cut beneath the ribcage.
- Hepatico-jejunostomy: Hepatico-jejunostomy ensures bile drains properly. Hepatico-jejunostomy treats benign and malignant strictures that arise due to gallstones, cysts and tumours found in the bile duct, gallbladder and liver. While the patient is under anaesthetic, the hepato-pancreaticobiliary surgeon makes a few incisions in the abdomen and cuts into the jejunum. He disconnects the hepatic duct from its junction and uses sutures to attach it the jejunum. Dr Pretorius reconnects the upper part of the cut jejunal tract to the lower region of the jejunum. In certain instances, a drain may be left to assist with aftercare. This drain is not permanent.
RECOVERY
Generally, patients return home on the day of the laparoscopic gallbladder surgery or the next day. It takes longer to recover from an open procedure than it does from laparoscopic surgery. Post-surgery rehabilitation takes six weeks. During this time, the patient takes painkillers to alleviate post-surgical discomfort. Patients must also avoid strenuous exercise, weight lifting and may need to follow a special diet.
Many complications can arise when a gallstone blocks the gallbladder or the bile duct. One of these complications is inflammation of the gallbladder, also known as acute cholecystitis. When the stone blocks the bile duct, it can cause jaundice and infection of the bile. This condition is called cholangitis and may become life-threatening. Cholangitis is one of the emergencies that is treated with antibiotics and an ERCP procedure. Also, small stones may pass through the bile duct into the intestine spontaneously. These small stones can cause a condition called Biliary pancreatitis.
Most of these complications have similar symptoms. These symptoms are a mixture of jaundice, pain in the upper abdomen, which could feel like stomach pain, nausea, vomiting and fever.
BILIARY SURGERIES
Types of biliary procedures are:
- Bile duct exploration: Bile duct exploration is an operation of the bile duct to remove stones stuck in the bile duct that could not be removed via ERCP for whichever specific reason. It can also be done when there has been an injury to the bile duct. It is performed under anaesthesia. Dr Pretorius makes an incision on the abdomen, finds the bile duct and opens the duct. If an injury is to be repaired, this is done by the appropriate manner for the injury. If stones are stuck, they are removed with a special forceps. A special camera, called a cholangioscope, is placed up and down this duct to ensure it is cleared of stones before the opening is repaired or reconstructed.
- Cholecystectomy: Cholecystectomy is a procedure to remove the gallbladder. This procedure prevents the recurrence of gallstones, treats infection and relieves pain. Dr Pretorius performs minimally invasive cholecystectomy and inserts tiny tools through small incisions to remove the gallbladder. Open surgery is an alternative option. Open surgery, however, entails a longer cut beneath the ribcage.
- Hepatico-jejunostomy: Hepatico-jejunostomy ensures bile drains properly. Hepatico-jejunostomy treats benign and malignant strictures that arise due to gallstones, cysts and tumours found in the bile duct, gallbladder and liver. While the patient is under anaesthetic, the hepato-pancreaticobiliary surgeon makes a few incisions in the abdomen and cuts into the jejunum. He disconnects the hepatic duct from its junction and uses sutures to attach it the jejunum. Dr Pretorius reconnects the upper part of the cut jejunal tract to the lower region of the jejunum. In certain instances, a drain may be left to assist with aftercare. This drain is not permanent.
RECOVERY
Generally, patients return home on the day of the laparoscopic gallbladder surgery or the next day. It takes longer to recover from an open procedure than it does from laparoscopic surgery. Post-surgery rehabilitation takes six weeks. During this time, the patient takes painkillers to alleviate post-surgical discomfort. Patients must also avoid strenuous exercise, weight lifting and may need to follow a special diet.