Cholecystectomy (removal of the gallbladder)

Cholecystectomy - is surgical removal of the gallbladder. Performed at diagnosis cholecystitis (gallbladder inflammation) and its variants.

Types of operations

- Laparoscopic Cholecystectomy I (used most often)

- An open cholecystectomy (the old method is used less frequently).

Pain relief

General.

Duration of operation

It does not depend on whether open or laparoscopic surgery, and usually ranges from 30 minutes to 1 5 hours.

Specific terms

- Laparotomy - is opening (slit) of the abdominal cavity.

-   Celioscope   - Endoscope device designed for manipulation of the abdominal organs. Most have an outer diameter of 5-10 mm and a system of lenses attached to the camera. By laparoscopy is also attached optical cable, illuminated by "cold" light source (halogen or xenon lamp). Used complete with special laparoscopic instruments and endoscopic equipment.

- Laparoscopy - examination of the abdominal cavity through an opening in the abdominal wall with the help of an optical instrument laparoscope .

- Laparocentesis - puncture the abdominal wall using the "trocar" made to extract the contents of the pathological abdomen, such as in ascites fluid

- Drainage - installation of special plastic tubes (drains) for the outflow of wound, blood, body fluids, etc.

Technology of the operation

Outdoor cholecystectomy

The surgeon opens the abdominal cavity, for access to the gallbladder makes an incision in the midline of the abdomen above the navel or oblique incision in the right upper quadrant. Then the doctor examines the abdomen (abdominal inspection), removes the gallbladder, if necessary put drainage and sews.

Laparoscopic cholecystectomy

Now produced in 80-90% of patients, the choice of this method depends on the experience of the surgeon, operating equipment, the nature of inflammation in the gallbladder. In general, what kind of operation to do, the doctor decides.

At the beginning of operation with a tool do trocar in the upper abdominal wall in the umbilicus 4 holes - the two 5 mm diameter and two - 10 mm. Through one hole is introduced laparoscope   with a video camera to observe on the monitor the progress of the operation, three others - instruments (laparoscopic clamps, scissors).

The bubble is cut off and removed by the liver through one of the holes. After surgery, the wound diameter of 5 mm adhesive tape glued 10 mm - sutured with absorbable filaments.

The micro-laparoscopy, the so-called cosmetic procedure

In this case, the tools and a laparoscope a diameter of 2 mm, respectively, hole tools also make it small. The skin remains virtually invisible scars, and the bubble is removed through a single large aperture 10 mm in diameter - through the navel. This scar is almost imperceptible.

If during laparoscopic surgery, the doctor sees the processes that complicate the manipulation of the abdominal cavity (rough seam textiles, dense infiltration - cluster of inflamed tissue), then immediately moves to the open form of operation.

Post-operative mode

In the evening on the day of surgery, you can have a drink, turn and sit up in bed.

The next day - get up and walk and have (light diet).

The patient is assigned a diet number 5 (low-fat food, fractional diet, excluded meats and pickles)

The duration of hospitalization

In the traditional surgical technique for 6-8 days remove skin sutures. Discharged patient, depending on the condition, 10-15 days after the operation. Employability is restored in 1-2 months.

After laparoscopic cholecystectomy seams are usually not removed, the statement made in the 2-4 days after the intervention, the ability to work is reduced by 15-20 days.

Contraindications to laparoscopic intervention

Common

- Severe cardiopulmonary pathology,

- A bleeding disorder,

- Peritonitis,

- Inflammatory and infectious diseases of the abdominal wall,

- Late stages of pregnancy.

Local

- Acute cholecystitis   more than 3-4 days,

- Acute pancreatitis,

- Jaundice,

- Malignant neoplasms of the gallbladder,

- Extensive adhesions of the abdominal cavity,

- Calcification of the gallbladder wall,

- Cancer of the gallbladder.

Where to cholecystectomy

The operation was performed in virtually every hospital where there is operational, appropriate equipment and trained surgeon.

Cost of operation

Open cholecystectomy is free.

Laparoscopic surgery is paid. The average price in Moscow on 30-40 thousand rubles.

Treatment and prevention

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