Cholecystectomy

Cholecystectomy is the surgical removal of the gallbladder. Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. In 2011, cholecystectomy was the eighth most common operating room procedure performed in hospitals in the United States

1. Cholecystectomy

2. Contents Introduction Why gall bladder surgery is common nowadays? What are the indications? Types Operative Management Pre-operative Post-operative Risk factors Contraindications Lifestyle modification and physiotherapy management

3. Introduction A Cholecystectomy is a surgical procedure to remove gall bladder. It is one of the most common type of surgery done nowadays due to poor lifestyle. Gall bladder is a small organ under your liver. It is on the upper right side of your belly. Function – stores and releases bile juice to help digestive system break down fats.

4. Diagrammatic Representation

5. Why cholecystectomy is common? The most common issue occurred is the gallstones may form if the bile contains to much cholesterol, too much bilirubin or not enough bile salts. Excessive cholesterol occurs in body due to extra consumption of junk food, lack of physical activity and poor lifestyle. High saturated fat content food (meat pies, butter, ghee, cheese etc.)

6. Indications A cholecystectomy is mostly performed to treat gallstones and the complications they cause. Your doctor may recommend a cholecystectomy if you have: Gallstones in the gallbladder (cholelithiasis) Gallstones in the bile duct (choledocholithiasis) Gallbladder inflammation (cholecystitis) Large gallbladder polyps Pancreas inflammation (pancreatitis) due to gallstones

7. Types of cholecystectomy There are 2 types of surgery to remove the gallbladder: Open (traditional) method. In this method, 1 cut (incision) about 4 to 6 inches long is made in the upper right-hand side of your belly. The surgeon finds the gallbladder and takes it out through the incision. Laparoscopic method. This method uses 3 to 4 very small incisions. It uses a long, thin tube called a laparoscope. The tube has a tiny video camera and surgical tools. The tube, camera and tools are put in through the incisions. The surgeon does the surgery while looking at a TV monitor. The gallbladder is removed through 1 of the incisions. A laparoscopic cholecystectomy is less invasive. That means it uses very small incisions in your belly. There is less bleeding. The recovery time is usually shorter than an open surgery.

8. Operative management ( Pre-operative) A cholecystectomy is performed using general anesthesia, so you won't be aware during the procedure. Anesthesia drugs are given through a vein in your arm. Once the drugs take effect, your health care team will insert a tube down your throat to help you breathe. Your surgeon then performs the cholecystectomy using either a laparoscopic or open procedure.

9. During Procedures

10. Laparoscopic / Open

11. Post-operative Laparoscopic cholecystectomy. People are often able to go home the same day as their surgery, though sometimes a one-night stay in the hospital is needed. In general, you can expect to go home once you're able to eat and drink without pain and are able to walk unaided. It takes about a week to fully recover. Open cholecystectomy. Expect to spend two or three days in the hospital recovering. Once at home, it may take four to six weeks to fully recover.

12. Complications Some possible complications of a cholecystectomy may include: Bleeding Infection Injury to the tube (the bile duct) that carries bile from the gallbladder to the small intestine Liver injury Scars and a numb feeling at the incision site A bulging of organ or tissue (a hernia) at the incision site During a laparoscopic procedure, surgical tools are put into your belly. This may hurt your intestines or blood vessels.

13. PT Management/Diet Protocol Avoid Oily food for few weeks. Maintain cholesterol level. Practice Breathing exercises Avoid jerky movement PT gives knowledge in initial days after surgery how change position and back to ADL activities preventing further injury and fast recovery. Maintaining normal body physique

14. References Manipal Manual of Surgery Wikipedia Medical.student.orientation.com

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