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    Cholecystectomy

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    Alyssa Quilban Martinez
    This document discusses cholecystectomy, the surgical removal of the gallbladder. It begins with an overview of gallbladder anatomy and function. It then describes cholecystitis, inflammation of the gallbladder that can be acute or chronic. The pre-operative, operative, and post-operative processes are outlined, including symptoms, risk factors, diagnostic tests, surgical procedures, pre-op preparation, post-op care and monitoring, and specific care for a T-tube if present.

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    Cholecystectomy

    Uploaded by

    Alyssa Quilban Martinez
    67 views19 pages
    This document discusses cholecystectomy, the surgical removal of the gallbladder. It begins with an overview of gallbladder anatomy and function. It then describes cholecystitis, inflammation of the gallbladder that can be acute or chronic. The pre-operative, operative, and post-operative processes are outlined, including symptoms, risk factors, diagnostic tests, surgical procedures, pre-op preparation, post-op care and monitoring, and specific care for a T-tube if present.

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    This document discusses cholecystectomy, the surgical removal of the gallbladder. It begins with an overview of gallbladder anatomy and function. It then describes cholecystitis, inflammation of the gallbladder that can be acute or chronic. The pre-operative, operative, and post-operative processes are outlined, including symptoms, risk factors, diagnostic tests, surgical procedures, pre-op preparation, post-op care and monitoring, and specific care for a T-tube if present.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    67 views19 pages

    Cholecystectomy

    Uploaded by

    Alyssa Quilban Martinez
    This document discusses cholecystectomy, the surgical removal of the gallbladder. It begins with an overview of gallbladder anatomy and function. It then describes cholecystitis, inflammation of the gallbladder that can be acute or chronic. The pre-operative, operative, and post-operative processes are outlined, including symptoms, risk factors, diagnostic tests, surgical procedures, pre-op preparation, post-op care and monitoring, and specific care for a T-tube if present.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 19

    CHOLECYSTECTOMY

    ALYSSA JAMILLA Q. MARTINEZ


    LIRIO CLAIRE T. AZUL
    GALLBLADDER

    Stores and concentrates bile and contracts to force bile into the
    duodenum during the digestion of fats
    The cystic duct joins the hepatic duct to form the common bile duct
    The sphincter of Oddi is located at the entrance to the duodenum
    The presence of fatty materials in the duodenum stimulates the
    liberation of cholecystokinin, which causes contraction of the
    gallbladder and relaxation of the sphincter of Oddi
    500- 1000 ml of bile/day
    Cholecystitis

    Inflammation of the gallbladder that may occur as an acuteor chronic


    process

    Acute cholecystitis associated with gallstones (cholelithiasis)

    Chronic cholecystitis results in inefficient bile emptying and gallbladder wall


    disease cause a fibrotic and contracted gallbladder

    Acalculous cholecystitis occurs in the absence of gallstones and is caused


    by bacterial invasion via the lymphatic or vascular system
    Assessment

    N/V
    Indigestion
    Belching
    Flatulence
    Epigastric Pain (radiating to the scapula 2-4 hrs after eating fatty foods
    and may persist 4-6 hrs)
    Pain localized in RUQ
    Guarding, rigidity and rebound tenderness
    Mass palpated in RUQ
    Assessment

    MURPHYs SIGN ( cannot take a deep breath when the examiners


    fingers are passed below the hepatic margin because of pain)
    Increased Temp
    Tachycardia
    Signs of Dehydration
    Fever
    BILIARY OBSTRUCTION
    -Jaundice
    -Dark orange and foamy urine
    -Steatorrhea and clay-colored feces
    - Pruritus
    Risk factors:

    Women are more likely to get gallstones than men


    Anyone older than 60
    Pregnant or multigravidas
    Women taking ERT or birth control pills
    Obese
    People who have lost weight rapidly
    People who eat high-fat diet
    Diagnostic/Lab test

    Ultrasonography Gallstone

    CT Scan

    MRI

    Oral cholecystography

    Hepatobiliary Nuclear Scan

    Endoscopic ultrasonography
    Interventions

    NPO when N/V


    Administer Antiemetics, Analgesics
    Administer Antispasmodic (anticholinergics) relax smooth muscles
    Chronic Cholecystitis- eat small, low-fat meals
    Avoid gas-forming foods
    Surgical Interventions

    CHOLECYSTECTOMY - removal of the gallbladder

    CHOLEDOCHOLITHOTOMY incision in the common bile duct to


    remove the stone
    Pre-op

    Obtain informed consent.

    Reinforced to client and family the surgical procedure to be done, how


    long it will take, possible complications and preventive measures.

    Healt
    Post- op Interventions

    Monitor for respiratory complications caused by pain at the incision site

    Encourage coughing and deep breathing

    Encourage early ambulation

    Instruct the client about splinting the abdomen to prevent discomfort


    during coughing

    Administer Antiemetics, analgesics


    Post- op Interventions

    Maintain NPO status and NGT suction as prescribed

    Advanced diet from clear liquids to solids when prescribed and as


    tolerated by the client

    Maintain and monitor drainage from the T-tube, if present


    Care for the T-tube

    Place the client in Semi-fowlers position


    Monitor the output, amount, color, consistency and odor of the drainage
    Report sudden increase in bile output to the HCP
    Monitor for inflammation and protect skin from irritation
    Keep the drainage system below the level of the gallbladder
    Monitor for foul odor and purulent drainage report to HCP
    Avoid irrigation, aspiration, or clamping of the T-tube without HCP
    prescription
    As prescribed clamp the tube before a meal and observe for: abdl
    discomfort distention, nausea, chills and fever; unclamp the
    tube if N/V occurs

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