Gallbladder surgery

[criket955]

I recently had elevated liver enzymes (they were tripled). My GYN ordered them because I was going to start a drug study. I was taking Motrin for back pain. I stopped taking the Motrin for about 4 days and had the LFTs redrawn. They were doubled. My MD didn't think they had gone down enough so he ordered an abdominal ultrasound. On my u/s it showed that I had a huge gallstone. (3.02 cm). Last August, I came to the ER with severe abdominal pain and nausea and vomiting. I thought it was my gallbladder. The pain was across the upper portion of my abdomen and felt like fullness or gas under my diaphragm. I had a CT done and the ER doctor said that he saw no gallstones and that I just had a stomach virus. I still occasionally have milder pain that runs across my abdomen that will take my breath. I do have dry heaves about 4 mornings a week. Food doesn't really bother me. I do have heartburn occasionally and it mostly occurs if I have acidic drinks or nothing to eat at all. I have talked with a general surgeon and he suggested I have my gallbladder out at my convenience. I have had my LFTs redrawn and they are normal again. I have heard not to have my gallbladder out unless I have more episodes. I have heard get it out before I have another episode.

Some questions I have:
1.) At what size of a gallstone should a person have their gallbladder removed?
2.) At what size can you no longer have the procedure laparoscopically?
3.) Will lipotropic B12 injections affect my gallbladder? (I scheduled an appointment with my doctor to begin a weight loss program that includes a diet pill such as adipex and lipotropic injections)

[popett2]

I did put a stone on during a year, I had my gall bladder out in Aug 2010 the surgeon said they were small but I told him I had lost 5 pounds, 50% of pain has gone but i am still in pain occasionally sharp pain on right at front where gall bladder was, but have a pain constantly in left side front and back, under my ribs during the day, feel sick no i have not got heart burn or reflux highertiouse urnia and at night the weight of some thing inside goes over to the left when i sleep on left, then pains when getting up to a vertical position, takes one hour to get stable to centre it in stomach, as it is central during the day but stomach is swollen and painful, but moves when laying down during the night and when i use my upper abdominal muscle to move and get up it hurts. Has some one got the answer as the doc suggest another ulterscan will they ever get ot the bottom of it???

[ER_CCU_RN]

     I recently had Lap Chole done on Saturday, with an ERCP and stent placement done the day before. The surgery went w/o complications from the surgical teams standpoint. However the bladder was enlarged to the point it would not come out the initial tool and a 2" incision was made to allow the organ to be removed. The incision was midepigastric distal to the diagaphram.
     My problems began POD 1 with purple/black echymosis and swelling in the RLQ starting at Right Flank ending at the umbilicus incision increasing in size and darkness. Today is POD 5 and my penis is black/purple with significant swelling present. My Surgeon and his RN stated this is a normal reaction if he "hit a bleeder during surgery"
     Has this happened to anyone else who has had a Lap Chole?
Thanks for the feedback. Rick

[DR_RTewari]

Dear cricket 995
An asymptomatic gall stone can be left but in ur case- "it is not an asymtomatic stone". All your symptoms are due to the stone. MOST OF THE GALL STONES ARE NOT SEEN ON CT SCAN (Majority of people think that CT is more expensive and better so it will not miss gall stone), BUT FOR GALL STONE ULTRASOUND IS THE TEST (Sensitivity > 98%). Ur last year pain is very suggestive of stone pain. Even a asymptomatic gall stone of 3 cm should be removed. Laparoscopy can be done for any size stone (we crush the stone before removal through the same small incision).
Vit B12 will not cause any problem. But rapid wt loss increases the stone chances.
With gall stones and raised liver enzymes, one should always rule out the possibilty of enzyme elevation due to CBD stone and u just cant think that it is due to drugs (what is ur Alkaline phospahte and direct bilirubin value and size of CBD in ultrasound?). If it is high then get an MRCP done to rule out stone in bile duct.
You shuld surely paln for gall bladder surgey