Laparoscopic Cholecystectomy

2:11:00 AM

S U R G I C A L . C A S E

Cuti Deepavali ni aku tak balik pun cuti. Yelahhh, umi tak suruh balik pun. Katanya balik cuti Christmas 2 minggu nanti. Hoho. So aku and Audi pun duduk je laa berdua kat rumah ditemani Bobo. 

Alhamdulillah minggu ni ada rezeki dapat masuk Operation Theatre (OT) few times. First case was cholelithiasis The patient was a female, 26 years old. 

Came with complains of jaundice and epigastric pain. First time suffering this kind of pain. No family history. Diet was okay as well. Her stool was pale and her urine is dark-colour.

Image result for physical sign for abdomen

Image result for murphy's sign
Impotant table ni anak anak !

Mr. Ken decided to remove her gallbladder - Laparoscopic Cholecystectomy

Laparoscopic Cholecystectomy

Image result for laparoscopic cholecystectomy

Image result for laparoscopic cholecystectomy

What is laparoscopic cholecystectomy?

The surgery to remove the gallbladder is called a cholecystectomy (chol-e-cys-tec-toe-mee). The gallbladder is removed through a 5 to 8 inch long incision, or cut, in your abdomen. During an open cholecystectomy, the cut is made just below your ribs on the right side and goes to just below your waist.
A less invasive way to remove the gallbladder is called laparoscopic cholecystectomy. This surgery uses a laparoscope (an instrument used to see the inside of your body) to remove the gallbladder. It is performed through several small incisions rather than through one large incision, usually 4 incisions, each one inch or less in length.

What is a laparoscope and how is it used to remove the gallbladder?

A laparoscope is a small, thin tube that is put into your body through a tiny cut made just below your navel. Your surgeon can then see your gallbladder on a television screen and do the surgery with tools inserted in three other small cut made in the right upper part of your abdomen. Your gallbladder is then taken out through one of the incisions.

Image result for laparoscopic cholecystectomy

Are there any benefits of laparoscopic cholecystectomy compared with open cholecystectomy?

With laparoscopic cholecystectomy, you may return to work sooner, have less pain after surgery, and have a shorter hospital stay and a shorter recovery time. Surgery to remove the gallbladder with a laparoscope does not require that the muscles of your abdomen be cut, as they are in open surgery. The incision is much smaller, which makes recovery go quicker.
With laparoscopic cholecystectomy, you probably will only have to stay in the hospital for a few hours or overnight. With open cholecystectomy, you would have to stay in the hospital for about five days. Because the incisions are smaller with laparoscopic cholecystectomy, there isn't as much pain after this operation as after open cholecystectomy.

Is there any reason why I wouldn't be able to have a laparoscopic cholecystectomy?

If you have previously had surgery in the area of your gallbladder, if you tend to bleed a lot or if you have any problem that would make it hard for your doctor to see your gallbladder, an open surgery may be better for you. Sometimes, your surgeon may begin doing the procedure laparoscopically and then convert to an open procedure.  Your doctor will decide which type of surgery is best for you.

What are the complications of laparoscopic cholecystectomy?

Complications may include bleeding, infection and injury to the duct (tube) that carries bile from your gallbladder to your duodeunum (small intestine). Also, during laparoscopic cholecystectomy, the intestines or major blood vessels may be injured when the instruments are inserted into the abdomen. All of these complications are rare.

Image result for cholelithiasis or cholecystitis
Image result for cholelithiasis or cholecystitis

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