Tuesday, April 23, 2013

512 stones found in Gall bladde

(Dr. B C Shah recently performed Laparoscopic Cholecystectomy on Mr. N_____ G______ who had 512 stones!)
Mr. N_____ G______ came to me with history of chronic pain in upper abdomen. The pain would get aggravated after meals. His sonography revealed that his gall bladder was distended & full of stones. I performed Laparoscopic Cholecystectomy on him. It was a difficult case as there were lot of adhesions. The gall bladder was delivered successfully  It was a pleasant surprise to find 512 stones in the Gall Bladder. 
One often wonders as to why patients wait so long. Many times patients come to me with Gall Stones. Often they have only one small stone. The common question asked is "Do I still need surgery for just a small stone?"
As per my observation of last 23 years, one stone or many stones – all have a potential to create complications including even death. Its not just the numbers or size. One small stone can just simply slip into the bile duct and is sufficient to trigger Pancreatitis. I personally know of a patient who developed severe pancreatitis due to a 3 mm small stone. She battled for two months in one of the best hospitals in Mumbai and ultimately died. 
In kidney stones, one of the criteria on which the therapy is based is the number of stones and its size. Smaller stones can pass out spontaneously and the patient's problem gets solved naturally. However, this is not the situation with gall stones. A gall stone or its fragment passing out can be dangerous as it can cause blockage of bile in liver or swelling in pancreas. Such complications can occur any time and no doctor on earth can predict when this will occur.
Many patients wait for the stones to grow and multiply. Surely this has a potential of inviting big untimely trouble. Don't wait. There are no warning signs.As far as records go, the largest number of gallstones removed was 3,110 in an open surgery in Britain in 1983, reported in the Guinness Book of World Records. 

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