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No more gallbladder removal

Published on 19.01.2012

Gallbladder removal doesn't need anymore

Surgery to remove the gallbladder, known as a cholecystectomy, is one of the most common surgeries done in the United States, performed on more than half a million people each year. The surgery is chosen when other methods, such as medications or ultrasound to break up the stones (lithotripsy) have not been successful in relieving symptoms or eliminating the stones.

Conventional cholecystecomy involves removing the gallbladder by one of two methods: laparoscopically through four small incisions in the abdomen with the assistance of a tiny video camera; or through one large incision in the abdomen. Both methods are associated with side effects and complications, although the laparoscopic technique, which is more common, is less risky.

A team of scientists in China, however, have developed a device that allows removal of gallstones without taking out the gallbladder. The patented, specially designed endoscope allows clinicians to locate and remove gallstones and other gallbladder lesions by sucking them out of the body like a vacuum.

In the American Institute of Physics’ Review of Scientific Instruments, the scientists describe how the ultrasonic probe at the end of the endoscope can find even the smallest gallstones. The new device also has a channel so fluids can be injected into the gallbladder to make it easier for clinicians to do the procedure, and it also can connect to any type of camera system.

Use of the new device was compared with another type of endoscope at two hospitals, and there was reportedly “no significant difference” in safety between the two methods. In addition, the authors report that the new device provides better flexibility, reliability, and image quality than existing methods.

Gallstones are pebble-like objects that form when liquid (bile) stored in the gallbladder hardens. Bile is a mixture of water, proteins, fats, cholesterol, bile salts, and bilirubin, which is a waste product.

Gallstones can be as small as a grain of sand or as large as a golf ball. Two types of gallstones can occur: those composed largely of hardened cholesterol, which is the case about 80% of the time; or pigment stones, which are composed of bilirubin.

The exact cause of gallstones is not known, although there are established risk factors. Some of them include

  • Diet high in cholesterol and fat and low in fiber
  • Rapid weight loss, which causes the liver to secrete extra cholesterol into bile, which in turn can cause gallstones
  • Being overweight, as this reduces the amount of bile salts in bile, which in turn increases cholesterol
  • Age over 60, because the body secretes more cholesterol into bile as we age
  • Use of cholesterol-lowering drugs, which can raise the amount of cholesterol secreted into bile

Development of this new device that makes gallbladder removal unnecessary is a significant advance and will be most welcome by individuals who develop gallstones that need to be removed. The new device is not available in the United States and any other countries.

American Institute of Physics, paper accepted for publication in the Review of Scientific Instruments
National Institute of Diabetes and Digestive and Kidney Diseases