Talk:Cholecystectomy

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I had a CHOLECYSTECTOMY in 1995, I have had bile salt diarrhea ever since, only this year did a doctor confirm that my issues were because of the CHOLECYSTECTOMY and prescribed Prevalite powder (Cholestyramine aka Questran). I couldn't eat fatty foods, spicy foods, very sugary foods (not even Pepsi)... It was horrible. Had instances of fecal incontinance... No doctor ever told me about a bile acid supplement, or BSD, I finally went to a gastro doc and he asked me one question... have you ever tried Questran... I cried, because I had read about it only days before my appt, now my life is so much better. I am 41, too young for depends diapers and thanks to that gastro doc, I can live again. I take one teaspoon per day and my BSD issues are 99% better.
Rayezer1 (talk) 21:19, 9 September 2010 (UTC)
thread_title: CHOLECYSTECTOMY in 1995

message: I would like to see the final paragraph in this article substantiated "Once a gallbladder is removed it is important to be on bile acid supplements. They need to be taken with every meal in which fat is consumed otherwise your fats will not be properly emulsified and absorbed."  I could only find one source on the web making this claim and it did not cite any sources.  I think this claim should be substantiated or removed. Asturnut (talk) 04:13, 10 September 2008 (UTC)
thread_title: final paragraph

message: Some of the information in this article appears to be outdated.  The primary source for this article seems to be  this document, which appears to be at least 12 years old. (Its most recent reference is from 1992).  Specific concerns are as follows:
*I believe, based on personal experience, that the rate of conversion to open cholecystectomy is lower than 5%, in the past decade surgeons have gotten much better at this procedure.
*It is not my understanding that cholecystectomy is indicated only by the presence of gall stones. I have heard surgeons, on a routine basis, give cholecystitis (inflammation of the gall bladder) as the pre-operative diagnosis for cholecystectomies.
*I have heard surgeons state that the non-operative treatments for gall stones have been shown not to be effective, and that the removal of the gall bladder is the standard of care for the treatment of gall stones
*The training of general surgeons has incorporated laparoscopic techniques for over a decade. And, so far as I know, institutions no longer keep separate credentialing procedures for laparoscopic surgery.
My opinions are based on over a decade of assisting surgeons as a Surgical Technologist. However, I am not a physician and do not have the formal training with which to refute the statements in the articles from personal knowledge, nor do I have easy access to the relevant research materials, so I am unwilling to change documented statements without a stronger or more recent authority. Dsmdgold 02:42, Feb 7, 2005 (UTC)
---
I mostly agree on the first three points you make, and as for the last one, I don't know. I guess it varies from              place to place.
The conversion to open cholecystectomy is also made when stones have made their way outside the bladder and when the anatomy is unclear, and the surgeon told me that it's about 5-10% of the operations they do that they have to convert.. So that number isn't really bad..
The standard care for treatment of cholecystitis and gallstones is nowadays a cholecystectomy. But only if you've had problems with the stones. If they're just there and don't make any noise, they will probably not be removed.. --HenrikP 16:47, 5 September 2005 (UTC)
thread_title: information in this article appears to be outdated

message: Is there anyone out there that can answer the following question for me: How does a cholecystectomy affect digestion?
:Aside from disruptions (e.g. ileus) that are common post-op in the first few days with any abdominal surgery, there is a period of adjustment after a cholecystectomy; diarrhea is common and may last for 3-4 weeks. Pain is also common, but that ought to be well controlled with analgesics.  
:Aside from diarrhea, if the person previously associated pain with eating or frequently got pain at night (several hours after eating), they'll feel relieved that they won't have it. (Classically, pain starts several hours after a meal in cholecystitis and is especially bad after a fatty meal.) Feel free to update the article with any other info you find... it could use some improvement. Nephron  T|C 03:01, 12 May 2006 (UTC)
replies: text: The liver makes a little bile all the time. Normally the bile goes to the gall bladder. The gall bladder holds onto the bile. Eating fatty food makes the gall bladder put all the bile in the intestines. Bile dissolves the fat. If you don't have a gall bladder then the liver puts bile into the intestines. The intestines don't hold onto it. You can't digest a lot of fat at once anymore. If you eat too much fat then you will get diarrhea. It's okay to eat fatty food very slowly. Then the liver's bile can keep up. 76.185.59.253 (talk) 08:20, 9 March 2010 (UTC)
thread_title:  cholecystectomy and digestion 

message: I have a close friend who after her cholecystectomy is experiencing tachycardia.
She has to take medication to control this and also experiences poor circulation, occasionally blueness of the lips and fingertips / nails. She is always very cold now and pale. But the medication she takes now controls the heart problems. She is only 23 and this has only started after her operation.
Does anyone know what could cause increased heart rate and poor circulation after having the gallbladder removed?
Adamld85 23:58, 14 November 2006 (UTC)
thread_title:  tachycardia after cholecystectomy 

message: "As many as 20% of patients develop chronic diarrhea." The sources listed don't seem to actually support that figure.
Also, the article on gallstones says "...a 10% risk of developing chronic diarrhea."
Surely the two articles should agree on the percentage, whatever it is.
Jaydeecw (talk) 02:45, 12 November 2013 (UTC)
thread_title:  Diarrhea 

message: no page for open chole. redirects here and needs to be discussed as an alternative (if unclear critical view, as part of liver txp) BakerStMD 16:30, 22 May 2015 (UTC)
thread_title:  To do: discuss open chole 

message: doi:10.1056/NEJMra1411372 - doesn't discussed traditional open cholecystectomy much! JFW | T@lk 20:37, 23 July 2015 (UTC)
thread_title:  NEJM 

message: Hello fellow Wikipedians,
I have just modified  on Cholecystectomy. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
*Added archive https://web.archive.org/web/20070702214922/http://www.webmd.com:80/hw-popup/Postcholecystectomy-syndrome to http://www.webmd.com/hw-popup/Postcholecystectomy-syndrome
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thread_title:  External links modified 

message: As part of the UCF College of Medicine Wiki Project we suggest the following changes to this article:
- Update the references to include up-to-date information, more secondary sources instead of primary, and statistics on procedure conversion rate, complications and prognosis.\
 
- We will try to update some of the photos to make the article more clear to laypeople.
- We will re-write and summarize key points of the contents to replace current lead section.
 
- Expand and edit the indications sections to include contraindications.
- In laparoscopic cholecystectomy section, we intend to clean up the last paragraph regarding comparison of SILS to traditional laparoscopic cholecystectomy to make it easier to read and understand for the layperson. 
- In the open cholecystectomy section, we will include reference to confirm complications due to open chole. 
- The procedural risks and complications section needs references confirming the statements made as well as editing to make the points in the paragraph more clear.TimFutureSurgeon (talk) 19:50, 15 January 2018 (UTC)
thread_title:  WikiProject Medicine 

message: Based off the original plan, it looks like many of the stated goals were accomplished. A couple that are specific that I noticed upon looking at the changes were:
- Update the references to include up-to-date information, more secondary sources instead of primary, and statistics on procedure conversion rate, complications and prognosis. ✔
- We will try to update some of the photos to make the article more clear to laypeople. ✔
- In laparoscopic cholecystectomy section, we intend to clean up the last paragraph regarding comparison of SILS to traditional laparoscopic cholecystectomy to make it easier to read and understand for the layperson. ✔
- We will re-write and summarize key points of the contents to replace current lead section. ✔
- The procedural risks and complications section needs references confirming the statements made as well as editing to make the points in the paragraph more clear ✔
Overall it looks like both UCF editors and other editors worked together to improve the overall look of the article as well as adding some up to date references and information. New sections were added it appears, including a History, Biopsy, Risks and Contraindications sections. Since these sections are so new there is more work to be done to expand upon them, but it is a great start.  — Preceding unsigned comment added by Ksmcnally (talk • contribs) 07:38, 31 January 2018 (UTC)
thread_title:  UCF Wikiproject user review 

message: Great work!  The introduction section is clear and concise, giving a brief overview of main topics.  The picture of gallbladder anatomy is perfect for this article.  Under the medical use section the terms symptomatic gallstones or biliary colic could possibly be added.   These indications are covered using the other terms however may be a little more comprehensible to the common population.  There is also a Wiki page on biliary colic that may provide additional information to the reader.  The contraindications section is a good addition.  You could possibly add some relative contraindications to laparoscopic surgery.  The section on single incision surgery is very easy to read and comprehend.  Overall the editors followed and accomplished their intended plan to improve this article and make it more comprehensible. Msmith191 (talk) 13:45, 31 January 2018 (UTC)
thread_title:  Peer Review for UCF WikiProject Medicine 

message: Hey Drusia,
Great work with your edits, and thank you for your time and commitment to this article! I reviewed your “Indications” section and “Alternatives to Surgery,” and they are both well-organized, clear, and easy to understand. Before I comment on those individually, I would like to add that I agree that the title “Indications” seems more accurate than “Medical Use” – considering it in context of a sentence, one would say “these are the indications for surgery” rather than “these are the medical uses of surgery.”    
Here are my suggestions for each part!
Indications: 
* The image is great but the titles are really hard to read. Is it possible to edit it (just by adding white textboxes with the words typed out instead of handwritten). I would probably also move it down to the procedure section
* I would mention that biliary colic is caused by the gallbladder contracting and usually happens after meals
Alternatives: 
* Rather than bullets, I would suggest making three subheadings (Conservative, ERCP, Cholecystostomy) and putting the info under each subheading. 
* In the conservative management section, I would add a few words to the end of the second sentence to say what the symptoms of gallstones are  
* If you have the time, I would consider adding an image for the ERCP section 
* In the cholecystostomy section, I would say that it’s a temporary measure and that definitive treatment is still gallbladder removal. I also saw this in an emedicine article which may be helpful to add: “In a retrospective study of patients with acute cholecystitis who were at very high surgical risk, Furtado et al found that although percutaneous cholecystostomy was a life-saving maneuver, it gave rise to significant morbidity, with a 44% rate of choledocholithiasis, a 27% rate of tube dislodgment, and a 23% rate of postoperative abscess.”
Again, great job with the article!  — Preceding unsigned comment added by UCSFMS3T (talk • contribs) 19:26, 23 March 2018 (UTC)
thread_title:  Peer Review UCSF WikiMed (Drusia) 

message: Overview
I mainly focused on the wording and the references during this peer review. 
Love the way the way the sentences are formed! Well written, clear, and you guys overall avoided too dense of a terminology. Also noticed you guys avoided using words like "patients" and instead used words like people, which is awesome. 
The structure is really nice and flowed well and logically, making things easy to find. Also really like the links to other wiki pages.
There were 2-3 references that were a little outdated and I tried to find alternate or additional links. I do feel that the sections on the technique of laparoscopy and open chole where written with too much jargon. Simplifying the language would be helpful. 
I loved this page and felt it was very thorough and well done!
My opinion on wording (take with grain of salt):
- For Lead and in Medical Uses, maybe mention a little more detail on what is symptomatic gallstones. For example, pain and inflamed gallstones
- In acute cholecystitis, I got the sense that infection is synonymous with acute chole (which sometimes doesn't come with infection), you guys could add a modifier like "sometimes"
- The description of the pathophysiology of cholangitis and gallstone pancreatitis felt a little dense to me. Maybe you guys can just mention that it's a blockage in a duct that connects both gallbladder and pancreas (the links out can give more detail)
- I also feel the description of the laparoscopy and open chole has a little too much jargon. Maybe translate some terms like fundus and superiorly. Or you guys can even simplify the whole paragraph even further. 
- I think it might be good to mention where the large data is coming from. In the other complications section, maybe mention it's from North America. 
Things on references/links: 
- For the post-cholecystectomy syndrome, the reference is from 2010. I found one from 2018 if you want to use it, https://www.nhs.uk/conditions/gallbladder-removal/risks/
- I found an additional and more recent reference for acalculous cholecystitis if you guys want to use it, http://www.cghjournal.org/article/S1542-3565(09)00880-5/fulltext
- You can also link chronic cholecystitis, I found a wiki link, https://en.wikipedia.org/wiki/Cholecystitis#Chronic_cholecystitis
- For citation 30, I found a more updated citation, https://www.cancer.org/cancer/gallbladder-cancer/treating/surgery.html
Great work guys!
 Yaya.wu (talk) 06:10, 26 March 2018 (UTC)
thread_title: Peer Review for WikiMed

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