Dr Chirag J Shah - Gallbladder Stone Removal Doctor in Ahmedabad, Gujarat, Rajasthan

• The most common symptoms of cholecystitis are
• Sharp pain in the right abdomen
• Low fever
• Nausea and bloating
• Jaundice (yellowing of the skin) may occur if gallstones are in the common bile duc

• HISTORY AND PHYSICAL EXAM
• Your healthcare provider will ask you about your pain and any stomach problems.
• ADDITIONAL TESTS (SEE GLOSSARY)
• Other tests may include
• Blood tests, including complete blood count right abdomen
• Liver function tests
• Coagulation profile
• Abdominal ultrasound is the most common study for gallbladder disease. 1-2 You may be asked not to eat for 8 hours before the test.
• Hepatobiliary iminodiacetic acid scan (HIDA scan)
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Magnetic resonance cholangiopancreatography (MRCP)

watchful waiting is recommended if you have gallstones but do not have symptoms. About 1 in 5 newly diagnosed patients with acute cholecystitis who do not have surgery readmit to the emergency room within about 12 weeks.

• GALLSTONES ONLY, WITHOUT CHOLECYSTITIS
• Increase your exercise. Exercising 2 to 3 hours a week reduces the risk of gallstones.
• Eat more fruit and vegetables, and eat less of foods high in sugars and carbohydrates like donuts, pastry, and white bread.

Four of 100 gallbladder removals are done in children. Almost 70% of children with gallstones do have symptoms. Symptoms in children include abdominal pain, nausea, vomiting, jaundice, fatty food intolerance, and fever. Children also receiving continuous IV nutrition and those with long-term antibiotic use, cystic fibrosis, obesity, or a family history have a higher chance of developing gallstones. Nearly 50% of all children with sickle cell disease develop gallstones and should have a screening ultrasound. Children with cholecystitis confirmed by ultrasound, those with severe pain, or those not able to take food or fluids should be evaluated for surgery.

Do not eat for 4 hours or drink anything but clear liquids for at least 2 hours before the operation.

Shower and clean your abdomen and groin area with a mild antibacterial soap.

Brush your teeth and rinse your mouth out with mouthwash.

Do not shave the surgical site; your surgical team will clip the hair nearest the incision site.

• WHAT TO BRING
• Insurance card and identification
• Advance directives (see Glossary)
• List of medicines
• Loose-fitting, comfortable clothes
• Slip-on shoes that don’t require that you bend over
• Leave jewelry and valuables at home
• WHAT YOU CAN EXPECT
• An identification (ID) bracelet and allergy bracelet with your name and hospital/ clinic number will be placed on your wrist. These should be checked by all health team members before they perform any procedures or give you medication. Your surgeon will mark and initial the operation site
• FLUIDE AND ANESTHESIA
• An intravenous line (IV) will be started to give you fluids and medication. For general anesthesia, you will be asleep and pain-free. A tube will be placed in your throat to help you breathe during the operation. For spinal anesthesia, a small needle with medication will be placed on your back near your spinal column
• AFTER YOUR OPERATION
• You will be moved to a recovery room where your heart rate, breathing rate, oxygen saturation, blood pressure, and urine output will be closely watched. Be sure that all visitors wash their hands.
• PREVENTING PNEUMONIA AND BLOOD CLOTS
• Movement and deep breathing after your operation can help prevent postoperative complications such as blood clots, fluid in your lungs, and pneumonia. Every hour, take 5 to 10 deep breaths and hold each breath for 3 to 5 seconds. When you have an operation, you are at risk of getting blood clots because of not moving during anesthesia. The longer and more complicated your surgery, the greater the risk. This risk is decreased by getting up and walking 5 to 6 times per day, wearing special support stockings or compression boots on your legs, and, for high-risk patients, taking a medication that thins your blood.

THINKING CLEARLY

If general anesthesia is given or if you are taking narcotic pain medication, it may cause you to feel different for 2 or 3 days, have difficulty with memory, or feel more fatigued. You should not drive, drink alcohol, or make any big decisions for at least 2 days.

NUTRITION

When you wake up, you will be able to drink small amounts of liquid. If you do not feel sick, you can begin eating regular foods.
Continue to drink lots of fl uids, usually about 8 to 10 glasses per day.
Eat a high-fiber diet so you don’t strain during bowel movements.

ACTIVITY

Slowly increase your activity. Be sure to get up and walk every hour or so to prevent blood clots.
ContDo not lift or participate in strenuous activity for 3 to 5 days for laparoscopic and 10 to 14 days for open procedure.
You may go home in 1 to 2 days for a laparoscopic repair. If your appendix ruptured or you have other health issues or complications, you may stay longer.
It is normal to feel tired. You may need more sleep than usual.

WORK AND RETURN TO SCHOOL

You may usually return to work 1 week after laparoscopic or open repair, as long as you don’t do any heavy lifting. Discuss the timing with your surgeon.
Do not lift items heavier than 10 pounds or participate in strenuous activity for at least 4 to 6 weeks.

WOUND CARE

Always wash your hands before and after touching near your incision site.
Do not soak in a bathtub until your stitches or Steri-Strips are removed. You may take a shower after the second postoperative day unless you are told not to.
Always wash your hands before and after touching near your incision site.
Do not soak in a bathtub until your stitches or Steri-Strips are removed. You may take a shower after the second post operative day unless you are told not to.
Follow your surgeon’s instructions on when to change your bandages.
A small amount of drainage from the incision is normal. If the drainage is thick and yellow or the site is red, you may have an infection, so call your surgeon.
If you have a drain in one of your incisions, it will be taken out when the drainage stops.
Steri-Strips will fall off in 7 to 10 days or they will be removed during your first office visit.
If you have a glue-like covering over the incision, allow the glue to fl ake off on its own.
Avoid wearing tight or rough clothing. It may rub your incisions and make it harder for them to heal.
Protect the new skin, especially from the sun. The sun can burn and cause darker scarring.
Your scar will heal in about 4 to 6 weeks and will become softer and continue to fade over the next year.
Sensation around your incision will return in a few weeks or months.

BOWEL MOVEMENTS

After intestinal surgery, you may have loose watery stools for several days. If watery diarrhea lasts longer than 3 days, contact your surgeon.

Pain medication (narcotics) can cause constipation. Increase the fiber in your diet with high-fiber foods if you are constipated. Your surgeon may also give you a prescription for a stool softener.

PAIN

The amount of pain is different for each person. Some people need only 1 to 3 doses of pain control medication, while others need more.

HOME MEDICATIONS

The medicine you need after your operation is usually related to pain control.

• Contact your surgeon if you have:
• Pain that will not go away
• Pain that gets worse
• A fever of more than 101°F or 38.3°C
• Continuous vomiting
• Swelling, redness, bleeding, or bad-smelling drainage from your wound site
• Strong or continuous abdominal pain or swelling of your abdomen
• No bowel movement 2 to 3 days after the operation

Everyone reacts to pain in a different way. A scale from 0 to 10 is used to measure pain. At a “0,” you do not feel any pain. A “10” is the worst pain you have ever felt. Following a laparoscopic procedure, pain is sometimes felt in the shoulder. This is due to the gas inserted into your abdomen during the procedure. Moving and walking help to decrease the gas and the right shoulder pain

Extreme pain puts extra stress on your body at a time when your body needs to focus on healing. Do not wait until your pain has reached a level “10” or is unbearable before telling you, doctor or nurse. It is much easier to control pain before it becomes severe.

COMMON MEDICINES TO CONTROL PAIN

Narcotics or opioids are used for severe pain. Possible side effects of narcotics are sleepiness, lowered blood pressure, heart rate, and breathing rate; skin rash and itching; constipation; nausea; and difficulty urinating.

NON-NARCOTIC PAIN MEDICATION

Most non-opioid analgesics are classified as non-steroidal anti-inflammatory drugs (NSAIDs). They are used to treat mild pain and inflammation or can be combined with narcotics to treat severe pain. Possible side effects of NSAIDs are stomach upset, bleeding in the digestive tract, and fluid retention. These side effects usually are not seen with short-term use. Let your doctor know if you have heart, kidney, or liver problems. Examples of NSAIDs include ibuprofen, Motrin®, Aleve®.

PAIN CONTROL WITHOUT MEDICINE

Splinting your stomach by placing a pillow over your abdomen with firm pressure before coughing or movement can help reduce the pain.

Distraction helps you focus on other activities instead of your pain. Listening to music, playing games, or other engaging activities can help you cope with mild pain and anxiety. Splinting Your Stomach

Guided imagery helps you direct and control your emotions. Close your eyes and gently inhale and exhale. Picture yourself in the center of somewhere beautiful. Feel the beauty surrounding you and your emotions coming back to your control. You should feel calmer.