Gallstones are the solid concretions varying in different sizes and shapes. These are formed in the gallbladder and appear to be the hardened deposits of the digestive fluid. Gallbladder is a small, pear-shaped organ which is located on the right side of the abdomen beneath the liver. A digestive fluid called bile is present in the gallbladder that is released into the small intestine.
There are two main types of gallstones:
There are a various factors that increase the risk of developing gallstones such as:
Usually, gallstones present no signs or symptoms. If a gallstone causes a blockage in the duct, the resulting signs and symptoms may include:
The pain caused due to gallstone formation may last for several minutes to a few hours.
Sudden Acute abdominal pain is the most common initial symptom of gallstones. Often located in the right upper belly just under the lower ribs. Sometimes this pain can be misleading to a heart attack. But the majority of people who have gallstones do not present any symptoms and their stones remain “silent.”
The complications associated with gallstones may include:
Spyglass Cholangioscopy is a novel technique developed for the visualization of bile ducts. It allows the doctor to observe the biliary duct system along with the small pancreatic ducts which are difficult to reach. It consists of a 6,000-pixel, fiber-optic probe which is attached to a tiny camera.
The procedure can be performed by an endoscopist. In the SpyGlass system, the endoscopes were fragile and difficult to use. The newer versions of the SpyScope provide better and easier visualization. The Spyscope is the endoscope used in SpyGlass cholangioscopy.
Many people undergo Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures to diagnose and treat diseases and conditions of the gallbladder, liver, pancreas, and bile ducts. Spyglass cholangioscopy aids in the direct examination of the bile ducts using a spyglass scope. This small caliber scope is inserted into the bile duct or pancreatic duct to enable the direct visualization during ERCP. It also helps to obtain biopsy specimens. This technology provides additional information beyond the standard fluoroscopic (x-ray) examination of the bile ducts and pancreatic ducts normally obtained during ERCP.
The small Spyglass scope is attached to the larger endoscope used for ERCP procedure. The Spyscope is composed of a lighted camera, an irrigation system and a suction to flush and clean out the debris. Additionally, the Spyscope has a working channel with a laser to break up stones and forceps for tissue sampling during biopsies.
Spyglass is a highly advanced and valuable tool used as an extension to standard ERCP. It enables the physician to diagnose and treat pancreatic and biliary diseases more efficiently and effectively.
For such large stones stuck in Bile duct, they can now be removed endoscopically using the latest “Spyglass Cholangioscopy” which is like baby scopy which enters the bile duct and by using the latest laser we can break the stones and successfully clear the bile duct without surgery. Since this is a day care procedure, the patient can go back home on the same day of the procedure.
About Author –
Dr. Adi Rakesh Kumar, Consultant Gastroenterologist,Therapeutic Endoscopist & Endosonologist, Yashoda Hospitals, Secunderabad
M.B.B.S, M.D., DM (Gastroenterology)
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