Biliary dyskinesia or “Lazy Gallbladder” is a functional disorder of the gallbladder. Patients with this condition can experience symptoms similar to those encounter in patients with gallbladder stones. The condition is also known as a non functioning gallbladder without stones.
This condition is not common and many times can be hard to diagnose if it’s not suspected. Many patients can be having intermittent symptoms for years before they seek medical attention or before it is suspected or diagnosed by the care providers.
Many patients with biliary dyskinesia will experience the classic symptoms of biliary colic or gallbladder pain. The classic symptoms are right upper abdominal pain that moves to the back or the right shoulder. The pain usually happens after eating a fatty meal.
Many patients will start with mild symptoms, and very infrequent. With time the symptoms tend to become more pronounce and frequent. Patients can also experience symptoms of indigestion like bloating, gas, abdominal distention, heartburn, nausea and/or vomiting.
The diagnosis of biliary dyskinesia can be hard to obtain because the classic tests for gallbladder pathology are usually negative. Most patients will have a negative ultrasound and/or CT scan.
The physical exam is usually negative and the typical blood test to evaluate the biliary system also tend to be normal.
The test of choice is the HIDA or PIPIDA scan with Ejection Fraction. This test will evaluate the function of the gallbladder. The test is said to be positive for biliary dyskinesia if the gallbladder ejection fraction is less than 38%.
In the present of correct symptoms and a low gallbladder ejection fraction on HIDA scan, the treatment of choice is a laparoscopic cholecystectomy or gallbladder removal surgery. Most patients will benefit from surgery in this scenario but there is a small percentage of patients that could have persistent symptoms.
The operation in Dr. Caban’s hands is routinely done laparoscopically or minimally invasive. Usually, four small incisions are done on the right side of the abdomen and using special instruments and a TV monitor the gallbladder is removed that way.
Patients with a prior history of open surgery might not be a candidate for a laparoscopic approach with other surgeons. Dr. Angel Caban has extensive experience with complex laparoscopic intraabdominal surgery. Most patients will be a candidate for laparoscopic gallbladder removal surgery in the hands of Dr. Caban.
Recently Dr. Caban completed a gallbladder removal surgery laparoscopic in a patient with a prior history of a gunshot wound to the abdomen requiring multiple abdominal surgeries.
In cases like the one above you should expect to have a longer operative time and/or more than 4 small incisions but even in that case your recovery will be faster and you will have less pain than if your surgery was done open.
After surgery, you will be in the recovery room for 2-3 hours. You will be discharged home with several days supply of pain medication. Most patients that have office type job can expect to return to work after 3-4 days. For those of you that have a heavy labor job were heavy lifting more than 15-20 pounds is necessary, you should account for 4-6 weeks out of work.
You will follow up with Dr. Caban in 2-3 weeks. At that time you will get the results of the gallbladder pathology. Gallbladder cancer is very rare but approximately 1% of all gallbladder surgeries will be positive for cancer.
Most patients won’t notice any changes from not having the gallbladder. A small percentage of patients will experience transient or chronic diarrhea especially after eating a high-fat diet. Most patients will go back to eat a normal diet, but some will need to limit the fat content on their diet.
“Dr. Angel Caban performed my surgery almost 5 years ago on 6/2/2014. He is a kind doctor and always treated me fairly. I always felt welcome in his office. I recommended him to many over the past 5 years”.
Gina
“Me encanta no lo cambio. Exelente el doctor caban y su personal. Muy buen grupo”.
Johanna
“Dr. Caban did my colon resection and did an outstanding job all the way across the board. I highly recommend him as well”.
Dan
“I have the privilege of working with Angel M Caban in the hospital environment. I also have had him be the surgeon to one of my family members. I would like everyone to know that he is a great surgeon. We are fortunate to have him here in Ocala. He is personable, easy to talk too and has excellent bedside manners”.
Karen
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