Ultrasound showing gallstones
Ultrasound (or ultrasonography) is a radiological technique that uses high-frequency sound waves to produce images of the organs and structures of the body. A transabdominal ultrasound is commonly used to diagnose gallstones. A transducer (a small device) is placed directly on the skin of the abdomen which has had a gel applied to it. It is painless, inexpensive, and without risk to the patient. In addition to identifying gallstones in the gallbladder, it can identify many other abnormalities related to gallstones including 1) the thickened wall of the gallbladder (in cholecystitis) 2) enlarged bile ducts due to gallstones obstruction 3) pancreatitis and 4) sludge.

Computed Tomography (CT)

Computed Tomography (CT) A computed tomography uses a finely collimated X-ray beam to scan through the area of interest. The test can be done with contrast and images taken at different phases. It obtains information about the body that is then processed by a computer into detailed multi-dimensional images or slices that demonstrate different types of tissues in the body at the same time.
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Magnetic Resonance Cholangio-Pancreatography (MRCP)

A picture of MRCP MRCP is a special type of magnetic resonance imaging (MRI) that produces detailed images of liver, gallbladder, bile ducts, pancreas and pancreatic duct. This uses a combination of a strong magnetic field and radio-waves to create a detailed image. There is no ionizing radiation. The overall examination time is approximately 30-60minutes.

MRI may not be suitable for some patients, for example someone with a pacemaker. You will be asked to complete a screening questionnaire prior to the scan. [click here for further information]



Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

ERCP - Gallstones removal An ERCP is an endoscopic test of the bile duct and, occasionally, the pancreatic ductA picture of ERCP. This is carried by passing the endoscope (a flexible tube) through the mouth. This test is usually performed with sedation. This involves injection into a vein of sedative (calming) drugs (usually a benzodiazepine and opioid agent). The test is often carried out to remove gallstones(s) in the main bile duct, or relieve bile duct obstruction (from stones) with a stent (plastic tube). [click here for further information]



Endoscopic ultrasound (EUS)

An illustration of EUS This test combines the modality of endoscopy with ultrasound to obtain clear images of the internal organs in the chest and abdomen. Like ERCP, this is carried by passing the endoscope through the mouth, under intravenous (injection into a vein) sedation. The procedure feels almost identical to the endoscopic procedure without the ultrasound part. The test can be an alternative to a MRCP for close inspection of common bile duct and gallbladder for microlithiasis (mini-stones/sludge).
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A cholecystectomy is an operation to remove the gallbladder and gallstones. Cholecystectomy Laparoscopic (keyhole) cholecystectomy is the most common way of having the gallbladder removed. The operation is carried out using a tiny camera and surgical instruments that are inserted through small incisions (cuts) in the abdomen.

The advantages of a laparoscopic (versus traditional open) cholecystectomy are:
1) Quicker recovery/earlier return to full activity or work
2) Less pain medication required
3) Shorter hospital stay
4) Less visible abdominal scar

Following surgery to remove the gall bladder by laparoscopic (keyhole) surgery, the patient will be able to go home 1–2 days after the operation and return to full activity and work by 2-3 weeks.

There may be conditions that make laparoscopic surgery difficult or unsafe. It is sometimes necessary to convert a laparoscopic procedure to a conventional open operation. In the event that open surgery is required, the patient should be able to go home 4-5 days after the operation and return to work 3-4 weeks after surgery.

There are risks and potential complications associated with the surgery. These will be discussed with you in detail before the operation.