CHOLECYSTECTOMY

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 )

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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

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• 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 .

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