Q. Is gallbladder removal necessary for multiple gallbladder stones with extrapancreatic walled-off necrosis?
Hello doctor,
My present condition is multiple gallbladder stones (size 2-5 mm. identified before four months) and asymptomatic extrapancreatic walled off - necrosis (size as per USG 8.7*5.1 cm identified a month back).
Complications: WON is abutting GB fundus.
I had acute pancreatitis. Gallbladder stones were also identified but not removed due to medical conditions. At that time I had severe pain, nausea, vomiting, and multiple organs were affected.
Presently, I do not have any symptoms like frequent vomiting, nausea, severe pain or fever. I had an occasional mild pain in the upper abdomen (very rare, especially when I take heavy food) and gas issues.
Below are the recommendations given by doctors. I request you to review my case and suggest the best:
1. Remove GB and possibly WON drain out in the same surgery if feasible. Please suggest what is the risk.
2. Remove only GB. Please suggest what is the risk in operating GB alone as WON is abutting GB.
3. Wait for another month before operating GB and WON. Please suggest if there is any risk in waiting as GB stones are still there.
I have attached the important reports for your review. Please let me know in case anything is needed from my side.
I am currently on Pantocid DSR, capsule Lupila-D, tablet Diapepsin P tablet Ulyses 300 mg and tablet Signoflam.
Hello,
Welcome to icliniq.com.
I have seen the reports (attachment removed to protect patient identity).
Do not worry. I will help you in this. First, I will tell you about gallbladder stones. So any gall bladder stones with history of pancreatitis or multiple gall stone should be removed. Laparoscopic cholecystectomy is the best recommended treatment.
Second is pancreatitis with WON. I will clear you in this regard that there is no need for any surgical treatment of acute or chronic pancreatitis with walled of necrosis. There are very few conditions where pancreatic surgery or drainage procedure is required like very large pseudocyst and more than 70 percent necrosis of pancreas. So in your case pancreatic WON drainage is not required.
One more thing to note is that if there is any attack of pancreatitis with WON gallbladder surgery should be postponed for minimum three months. This is the time to recover your body from the attack of pancreatitis.
I hope this helps.
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