CHOLECYSTECTOMY
Definition
– Removal of gallbladder is called as Cholecystectomy.
– Cholecystectomy means making an opening in gallbladder for removing gallstones at the neck of gall bladder and for draining the obstructed gall bladder.
* Indications
1) Gall stones ( cholelithiasis )
2) Acute and chronic cholecystitis
3) Carcinoma of gall bladder
4) Mucocoel of gall bladder.
– Acute cholecystitis frequently requires early Cholecystectomy.
* Types of Surgeries
– There are 2 types of Surgeries
(1) Open Cholecystostomy
(2) Laproscopic Cholecystostomy
• Open Cholecystostomy
– Patient is in supine lying Position.
– Procedure is done under spinal or general anesthesia.
• Incisions used in Cholecystectomy
✓ Supraumbilical midline incision
✓ Right upper paramedian Incision
✓ A subcostal incision
– Abdomen should be opened in layers and a regular Cholecystectomy has to be done in a routine manner
– Following surgical procedure a corrugated drain is left in position for about 48 to 72 hours to permit the drainage of bile and duct.
– And it is collected in a drainage bag .
– A nasogastric tube or Ryle’s tube is then inserted.
• Post operative complications
– Slow recovery of international persistalsis
– Bleeding
– Leakage ( at the site of operation )
– Pulmonary complication results from Diaphragmatic dysfunction occurs due to upper abdominal surgery.
– Retention of secretions
– Segmental collapsing of right lobe of lung
– Nasogastric tube should be aspirated before starting chest physiotherapy .
If it is not removed and if the stomach is not emptied while doing chest physiotherapy patient might vomit and this vomitus may enter into respiratory passage causes bronchospasm and aspiration pneumonia .
