Remove gallstones without removing gallbladder. Remove gallstones from the bile duct
If you're considering surgery, please send your ultrasound results to info@nogallstones.com
Gallstone Removal Surgery Without Gallbladder Removal
Our procedure involves removing gallstones while preserving the gallbladder.
Using advanced technology such as choledochofiberscopes, rigid choledochoscopes, laparoscopes, and other specialized equipment, we make a small incision (1.5 to 2 cm) in the area of the lower rib cage to access the abdominal cavity. A 5mm mini-laparoscope is then used to check the overall condition of the abdominal organs, as well as the size and positioning of the gallbladder, ensuring there are no tissue adhesions or abnormal growths.
Gallstone removal surgery is performed under general anesthesia. The procedure is carried out through small incisions, typically made in the following areas:
- Lower rib cage (1.5–2 cm)
- Umbilical region (0.5 cm)
During the procedure, we use advanced technology like choledochoscopes, choledochofiberscopes, and both rigid and flexible endoscopes. The use of both types of endoscopes provides a clear view of the condition of the mucous membrane, the number of stones, and their size and location.
A mini-laparoscope is inserted into the abdominal cavity through a small incision in the lower rib cage, allowing us to check the condition of the gastrointestinal organs and the gallbladder, including its size and any abnormal growths.
Next, we make an incision at the base of the gallbladder and insert a flexible tube, securing it with a purse-string suture.
The choledochoscope is then placed into the gallbladder through this tube, which minimizes trauma to surrounding tissues. This setup ensures a tight seal and prevents bile from leaking into the abdominal cavity, reducing irritation.
Using endoscopic graspers, we extract the gallstones. Larger stones or those in the bile ducts are first broken down using pneumatic lithotripsy.
After all stones are removed, we re-examine the gallbladder cavity and withdraw the choledochoscope. The incision at the base of the gallbladder is closed with absorbable sutures.
We use medical adhesive to seal the incisions in the right upper quadrant and the umbilical area. This closure method provides a secure bond and a good cosmetic result, leaving only a thin line.
The stones removed from the gallbladder are sent to the laboratory for analysis to determine their chemical composition.
Patients can usually stand and walk independently within 8 hours after the surgery. Most patients are discharged on the 4th or 5th day after the operation.
Gallstone Removal from the Bile Duct: The Procedure
When gallstones are detected in the bile duct via ultrasound, we recommend removing them immediately.
Why is this important? In most cases, gallstones can block the duct, which may lead to cholecystitis, an inflammation of the gallbladder.
Our unique minimally invasive endoscopic procedure for removing gallstones from the bile duct, developed by Professor Qiao Tie, is performed as follows:
- A guiding cap is placed on the end of the endoscope.
- The endoscope is then maneuvered and gently pressed into the bile duct to accurately diagnose the presence and location of the stones.
During the research and development of this procedure, Professor Qiao identified several key methods for extracting stones using different equipment:
- If the stones in the bile duct are relatively small and can be slightly mobile, and there is space between the stones and the wall of the gallbladder, they can be removed using a basket that first captures the stone and then extracts it from the bile duct.
- If the stones are soft enough to be broken down, special forceps are used to crush and remove them.
- In some cases, stones may be firmly lodged in the bile duct, meaning they have adhered to the duct wall. For these stones, we use pneumatic lithotripsy to break them apart directly within the duct. The fragments are then removed using a basket or forceps.
A successful procedure means that bile starts to flow freely from the duct after the stones are removed.
You can schedule a minimally invasive endoscopic procedure for gallstone removal from the bile duct after getting preliminary approval.
Please send your gallbladder ultrasound results to info@nogallstones.com to find out if you are eligible for this surgery.
Indications for Surgery:
- A single stone with an echogenic shadow larger than 4 mm or multiple stones of any size in the gallbladder.
- A single polyp in the gallbladder larger than 5 mm.
- Multiple polyps in the gallbladder of any size.
- One or more stones in the bile duct, or sand in the bile duct.
- Stones adhering to the walls of the gallbladder or embedded within them.
- Thick, putty-like bile with sand in the gallbladder or bile duct.
- Thick, stagnant bile with sand.
Contraindications for Surgery:
The following conditions may prevent the performance of gallbladder-preserving surgery:
- Previous abdominal or heart surgeries (each case is evaluated individually).
- Inflammation of the gallbladder (absence of pain and minor thickening of the wall at the gallbladder's base are not contraindications).
- Diabetes (subject to discussion).
- Ischemic heart disease.
- Tuberculosis.
- Liver cirrhosis.
- Choledocholithiasis (presence of stones in the common bile duct requires prior surgical intervention).
- Abnormally small gallbladder size.
- Body Mass Index (BMI) over 29 (evaluated individually).
- Atrophy of the gallbladder.
- Intrahepatic gallbladder.
- Mirizzi syndrome.
- Pyelonephritis (diagnosis must be confirmed).
- Acute pancreatitis.
- Overall health status that may preclude surgery.
- Suspicion of malignant tumors in the abdominal cavity.
- Age under 6 years.
Age over 60 is NOT a contraindication.
Having a mesh at the umbilical site, umbilical hernia, or multiple adhesions in the abdominal cavity is not a contraindication. In such cases, the surgery is performed through one incision in the right upper quadrant.
Each individual's health situation is unique, and exceptions may apply in specific cases.
You can schedule a minimally invasive endoscopic procedure for gallstone removal from the bile duct after receiving preliminary approval.
Please send your gallbladder or abdominal ultrasound, MRI, or CT results to info@nogallstones.com to find out if you are eligible for gallbladder-preserving surgery.