Laparoscopic cholecystecyomy is a minimally invasive surgery and this is very common in laparoscopic surgery in this procedure surgeon remove gallbladder due to gallstone in the gallbladder and infection in the gallbladder.
The gallbladder— a sac located near the liver that serves as a storage space for bile — can be stricken with various problems, such as gallbladder cancer or inflammation (called cholecystitis).
gallstones are also a common gallbladder problem, and infection can occur if the gallbladder remains blocked by a gallstone or continues to be inflamed.
Anatomy: gallbladder, liver, pancreas
What Causes Gallbladder Problems?
Gallstones in the gallbladder
Gallstones in the bile duct
Gallbladder inflammation
Large gallbladder poylps
Pancreas inflammation due to gallstones
Blood sugar imbalancs
Low stomach acid production
Obesity
Rapid weight loss
Chronic stress
What are the symptoms of gallbladder problems?
severe pain in the right upper abdomen and sometimes the right chest or back
Pain after eating, particularly high-fat foods, or at night
Fever, with shaking and chills, especially if occurring with, or after, abdominal pain
Nausea and vomiting
Heartburn and indigestion
Feeling of fullness in the abdomen, or excess gas.
Fatty and greasy stool
Light colored stool
Chronic gas bloating
Yellow of the skin due to jaundice
Headache and migraine
Constipation and diarrhoea
Bitter test in mouth
Constant runny nose
Weight loss resistance
Over the counter drug use
Pre-operative instruction for the patient:
If patient taking blood thinners like aspirin, plavix, coudamin discuss with surgeon whether patient should continue or stop medication before surgery.
If patient smoke its stop before the surgery because its increasing the risk of complications.
Don't eat or drink anything after midnight or night before come to the hospital.
Leaves valuable or costly items and accessories at home but come with medical insurance card and identity card
Before the surgery, patient undergo ultrasound sonography and imaging procedure, such as computed tomography (CT) and blood test, urine test and an assessment of cardiovascular fitness patient also meet with an anestheologists prior to the procedure. The preoperative blood testing is similar before either an minimally invasive cholecystecyomy or open procedure.
Laparoscopic cholecystecyomy done under the full general anesthesia General anesthesia for pain relief during surgery and comfort to patient.
Fentanyl citrate and muscle relaxtant given to the patient and Endotracheal intubation will given and hypnotic agent like propofol given.
Than anesthesist continue watching monitor and watch vital signs including pulse, spo2(saturation ), E.C.G, body temperature and blood until the patient will not shifted from operation theatre to general ward
What are the advantages of laparoscopic gallbladder surgery
Reduce blood loss and transfusion.
Reduce pain
Shorter hospital stay
Improved cosmesis
Fast recovery as compared to open surgery
How is Laparoscopic Gallbladder Removal Done?
In this procedure surgeon make four incision on the abdomen which is less than 1cm create pneumoperitoneum by co2 gas for big view field and for working space one port is for telescope and another two port is for working instruments and last port is for gallbladder fundus retractor.When surgery is finished, the surgeon closes your incisions with tiny stitches, staples, surgical tape or glue. These disappear as you heal, so the doctor does not need to remove them later.duration of surgery about 1 hours.
Incisions after minimally invasive (laparoscopic) surgery
After the surgery patient shifted to recovery room from the operations theatre for monitoring, respiratory status and vital signs for 2 to 4 hours then moved to general floor when patient stable , hospital stay of about one to two days benefits of laparoscopic or minimally invasive surgery is decreased length of hospital stay and dimnish pain and deceased respiratory complications.
Post op surgery :
Patient keep in recovery room for monitoring for few hours, then patient comfortable & fully come out from the anesthesia then patient shifted to ward.
Check urine output by nursing staff.urine should be cleared.
Check the vitals signs of the patient every one hour.
Give antibiotics to prevent infection.
Patient will feel some pain after surgery. Pain at the incision sites and in your abdomen is common. Patient might also have pain in shoulders. This is from the air put into your abdomen during the operation. The shoulder pain should go away in 24 to 48 hours.
Painkiller gives for reduce to pain.
Patient can ambulate (walk) with taking help of nursing staff from next day after the order by surgeon.
If catheter is present Catheter or foley's will removed after the 1 days by the instruction of surgeon.
Don't take solid food after surgery till five days (also as per doctor advise)
Complications of laparoscopic gallbladder removal (cholecystectomy)
-Bile leak
-Bleeding
-Infection
-Injury to near by structure like bile duct, small intestine and liver
After the discharge from the hospital :
If patient experience following
symptoms or problems then immediately contact the doctor:
-Severe persistent pain not relief by medication and rest.
-Difficulty obtaining medication any new onset of or increased weaknesses numbness or tingling.
-Persistent chills new onset of fever over 101° degree farehnit or night sweat.
-Any redness, swelling drainage, heat or pain around incision.
-Any new onset of chestpain or shortness of breathing.
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