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  LIFELONG LEARNERS

Open Gallbladder Surgery And Common Bile Duct Exploration



by Carmelita Cochingco Ballesteros.
July 1, 2011
A doctor I’ve just met the day before tells me that I need immediate surgery to remove my swollen gallbladder and to extract gallstones from my common bile duct.

“How soon?” I ask with shock and disbelief.

“Tomorrow,” he replies casually.

I’d like to share with you, dear readers, some information that might prove life-saving as regards the diagnosis, decision-making, and post-operation recovery involved in an open gallbladder surgery and common bile duct exploration. An open gallbladder surgery or cholecystectomy, according to the University of Maryland Medical Center (http://www.umm.edu) , involves the removal of the gallbladder through an incision in the abdomen. Immediately after the gallbladder is removed, a cut is made in the common bile duct in order to extract gallstones which are clogging it.

The American College of Gastroenterology (http://www.acg.gi.org) defines the gallbladder as the sac which stores bile from the liver while the common bile duct is the tube through which bile flows from the gallbladder and the liver to the small intestine.
Diagnosis.

Symptoms. My symptoms consisted of a bloated feeling, nausea, high fever, and dark yellow urine. The bloatedness and nausea bothered me only when I had a mild attack while teaching last July 19, 2011. I’d had previous similar attacks five months earlier, but they were mild, infrequent, and usually lasted for 30 minutes only. However, when I went home on July 19, I had a slight fever and I noticed that my urine had turned dark yellow. I learned from hindsight that these were alarming symptoms to watch out for.

The following day, I went to Makati Medical Center for a routine check-up. I simply looked in the hospital directory for the name of a gastroenterologist who was available in the morning. He was Dr. Carlo Cornejo whom I met for the first time. He thought I had urinary tract infection (UTI) and ordered a urinalysis. While waiting for the lab results, I started trembling like a leaf on a stormy day and I had a fever measuring 39.5 degrees Celsius.

Lab Tests. I was admitted on the same day, July 20, under the care of Dr. Cornejo. Advance blood chemistry tests and an abdominal ultrasound were done on me.

Recommended Course of Action. At around 1:30 p.m. on Thursday, July 21, Dr. Cornejo and Dr. Bobis, a resident doctor assigned to him, came to Room 923 to break the lab results to me. My gall bladder was swollen and my common bile duct was clogged with gallstones. The only remedy was immediate surgery.

Decision-making.
Surgery now or later. It was the middle of the trimester at De La Salle University-Manila where I am teaching, so I argued vigorously with Dr. Cornejo against his ‘irresponsible’ recommendation. But Dr. Cornejo countered that if he’d allow me to go home, I’d probably have blood poisoning and I’d be back soon and would be landing in the intensive care unit. I would be in a bigger mess which would be more difficult to fix. I didn’t realize that a swollen gallbladder meant I had an infection and that I could die from blood poisoning. Pride in my perfect attendance as an academic had to give way to the higher value of preserving life and good health.

Open surgery vs. laparoscopy. On Friday morning, July 22, Dr. Benedict Barretto introduced himself to me as my lead surgeon. He stayed for an hour and patiently explained the pros and cons of an open surgery as well as the noninvasive laparoscopy and ERCP (endoscopic retrograde cholangiopancreatography).

When Dr. Barretto left, I called and texted a number of friends and family members. The consensus was that there seemed to be no time for a second opinion, and the better option was open surgery so that the surgeons could have a good look at my insides and be able to flush out the sludge from my clogged bile duct.

The Surgical Team and Hospital Facilities. Makati Medical Center is considered as one of the best in the Philippines, so my family felt that I would be in good hands and I would receive excellent medical attention.

Post-Operation Recovery.
The First Days after the Surgery. I was opened up on Saturday morning, July 23. Two days after, I was on full diet and felt fine. There was hardly any pain, but it was inconvenient and uncomfortable being attached to an IV drip and having two tubes draining surgical fluid and bile attached to my stomach.

Post-Op Check-up. Having left the hospital on Wednesday morning, July 27, I had my first post-op check-up on Saturday, July 30. The T-tube was closed to observe if the bile would back-flow into the surgical drain. It didn’t, so the surgical drain was removed on Wednesday, August 03. But the T-tube will stay until mid-September.

Long-term Wellness. To help myself heal and to ensure long-term wellness, I have been taking my medicines regularly, walking, and taking in some sunshine. More importantly, I’ve been drinking malunggay tea, buko juice, guyabano juice, and cucumber-carrot-apple juice. Moreover, I’ve been eating dishes with generous helpings of malunggay leaves, and I’ve been eating papaya with every meal.

This food regimen is meant for detoxification as well as for boosting my immune system so that my body can heal naturally. My daughter-in-law, a recent cancer survivor, almost died from radiation and chemotherapy. Thus, she stopped the burn-and-poison prescription of mainstream medicine. She switched to the food regimen I’m having right now, and is in the pink of health today.

Remember, a timely and accurate diagnosis, a courageous decision made in humility, and a post-operation regimen of exercise, sunshine, and immune-boosting food could be life-saving for some potential gallbladder patients.

Although a doctor may discuss your medical situation nonchalantly with a boyish smile, it’s just his professional demeanor. Never put your health on the line with equal nonchalance.



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