Cholecystectomy: removal of the gallbladder; tx of choice for symptomatic gallstones
Planning: no obstruction or infection
Interventions:
Monitor for bleeding, make the patient comfortable, and prepare for discharge
Patient may report referred pain to the shoulder because of the CO2 that the HCP uses to
inflate the abdominal cavity during surgery which can cause difficulty breathing g place
pt on their left side with right knee flexed to move the gas pocket away from the
diaphragm
Encouraged deep breathing and ambulation
NSAIDs or codeine to relieve pain
Start clear liquids and walk to the bathroom to avoid
Wound care, cover incision
Antibiotics
Indications:
Gallstones (Cholelithiasis)
Symptomatic gallstones → causing biliary colic (RUQ pain after fatty meals)
Complicated stones → obstructing bile duct (choledocholithiasis)
Acute Cholecystitis
Gallbladder inflammation, often caused by stones
Symptoms: RUQ pain, fever, nausea/vomiting, positive Murphy’s sign
Chronic Cholecystitis
Recurrent mild inflammation → scarring and dysfunction of gallbladder
Gallbladder polyps (rare, especially if >1 cm or suspicious)
Gallbladder dyskinesia (poor emptying on HIDA scan)
Types of Cholecystectomy
1. Laparoscopic Cholecystectomy (Most common)
o Minimally invasive
o 4 small incisions
o Faster recovery (1–2 weeks)
o Less pain, lower infection risk
2. Open Cholecystectomy
o Traditional surgery through a large abdominal incision
o Used if complications:
Severe inflammation
Scar tissue from previous surgeries
Bleeding risk or anatomical variation
Planning: no obstruction or infection
Interventions:
Monitor for bleeding, make the patient comfortable, and prepare for discharge
Patient may report referred pain to the shoulder because of the CO2 that the HCP uses to
inflate the abdominal cavity during surgery which can cause difficulty breathing g place
pt on their left side with right knee flexed to move the gas pocket away from the
diaphragm
Encouraged deep breathing and ambulation
NSAIDs or codeine to relieve pain
Start clear liquids and walk to the bathroom to avoid
Wound care, cover incision
Antibiotics
Indications:
Gallstones (Cholelithiasis)
Symptomatic gallstones → causing biliary colic (RUQ pain after fatty meals)
Complicated stones → obstructing bile duct (choledocholithiasis)
Acute Cholecystitis
Gallbladder inflammation, often caused by stones
Symptoms: RUQ pain, fever, nausea/vomiting, positive Murphy’s sign
Chronic Cholecystitis
Recurrent mild inflammation → scarring and dysfunction of gallbladder
Gallbladder polyps (rare, especially if >1 cm or suspicious)
Gallbladder dyskinesia (poor emptying on HIDA scan)
Types of Cholecystectomy
1. Laparoscopic Cholecystectomy (Most common)
o Minimally invasive
o 4 small incisions
o Faster recovery (1–2 weeks)
o Less pain, lower infection risk
2. Open Cholecystectomy
o Traditional surgery through a large abdominal incision
o Used if complications:
Severe inflammation
Scar tissue from previous surgeries
Bleeding risk or anatomical variation
