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David A. Kloss

M.D., F.A.C.S.
Phone: (218) 631-3510
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Dr. Kloss
In the News

Dr. Kloss pioneers aortic stent graft procedure.


Dr. Kloss on screening colonoscopy
  • As talkshow guest

  • Surgical Services...


    Gall Bladder Surgery

    Gall bladder surgery is STILL the most common surgery in America. Gall bladder disease is very common in this country due to our diet heavy in fatty foods and high cholesterol foods. Our sedentary life style also plays an important role in the high incidence of gall stones.

    The gallbladder stores and releases bile into the intestine. The bile aids in the digestion of fats in our diet. Trouble comes when the bile, cholesterol, lecithin and water are present in the gall bladder in abnormal amounts. The cholesterol can precipitate and form crystals and eventually stones (gallstones) which can then cause great problems!

    About 20 million people in America have gallstones; they are more commonly found in women. Most gallstones never cause any symptoms and hence many people with gallstones never have surgery.

    Pain, fever, infection are some of the more serious consequences of gallstones that might force the need for surgery. But in most people, if you are not having any symptoms from the gallstones, don't go "looking" for trouble (there are some special groups of patients who should have the gallstones and gallbladder removed even if there are no symptoms).

    Sometimes the gallbladder causes symptoms that are very vague: symptoms can sound like heart burn or like a heart attack. Sometimes the symptoms are "classic": pain in the right upper abdomen hour after eating a fatty meal (like pizza). These symptoms might last for several hours and then gradually resolve.

    The evaluation for gallbladder disease can be straightforward (an ultrasound shows gallstones during a "classic" attack ); sometimes, however it can be much more complex requiring many tests trying to sort out the source of a person's vague symptoms. Occasionally a person can get very sick with gallstones: pancreatitis, jaundice (yellow skin) or high fever. If you are concerned about any of these types of issues, please report to the nearest emergency room for evaluation.

    The most common treatment for gallstones that are causing troubles is surgery (laparoscopic cholecystectomy). Other less successful treatments are: oral dissolution therapy (a pill) and shock wave lithotripsy (a blast of sound waves). These treatments take months to be effective and put the patient at risk for recurrent problems.

    With laparoscopic gallbladder surgery the incisions are very small, pain level fairly small and return to activity quick. Patients do very well after the surgery. Almost all patients return to normal eating (Yeah! Pizza and ice cream again!). Some patients have some diarrhea from dairy products for a short time after surgery. There does not seem to be any long term ill-effects from having the gall bladder removed.

    Several real surgical photographs are included here to show how this minimally invasive surgery works!

    Images of laparoscopic gall bladder surgery Photos of instruments used during laparoscropic gall bladder surgery
    Pictured above, gall bladder and small surgical instruments
    The cystic artery and the micro clips; getting ready to cut the cystic artery.
    Clip and transect cystic artery during gall bladder surgery Gallbladder removal surgery images
    The cystic artery has been clipped and transected and we are getting ready to clip and cut the cystic duct.
    Image of gall bladder removal Photo of gallbladder dissected off liver bed Image of gall bladder removal surery
    Off comes the gallbladder, dissected off the "liver bed". This is the membranous attatchment between the gallbladder wall and the liver.
    Image of removed gall bladder
    Out comes the gallbladder! It "pops" out of the umbilical incision! You go home the same day with "skin glue" on the incisions!

    Laparoscopic gallbladder surgery is done as an outpatient. Return to work depends upon the type of work the patient does; with a light desk job it might be possible to return to work in 1-2 weeks. Someone who performs heavy manual work will probably be out of work for 4 weeks to avoid straining the sutures of the umbilical incision.

    If you have more questions about gallbladder surgery or whether or not your symptoms are related to gallbladder disease ask your medical doctor; if it seems appropriate she will make an appointment with Dr. David A. Kloss.

    415 Jefferson Street North   •   Tri-County Hospital   •   Wadena, Minnesota