prothrombinlevel is low. Blood component therapy may be administered before
surgery. Nutritional requirements are considered; if the nutritional status is
suboptimal, it may be necessary to provide intravenous glucose with protein
hydrolysatesupplements to aid wound healing and help prevent liver damage.
Preparation for gallbladder surgery is similar to that for any upper abdominal
laparotomyor laparoscopy.
Cholecystectomy
In this procedure, the gallbladder is removed through an abdominal incision
(usually right subcostal) after the cystic duct and artery are ligated. The
procedure is performed for acute and chronic cholecystitis. In some patients a
drain may be placed close to the gallbladder bed and brought out through a
puncture wound if there is a bile leak. The drain type is chosen based on the
physician‘s preference. A small leak should close spontaneously in a few days
with the drain preventing accumulation of bile. Involves an incision into the common duct, usually for removal of stones.
After the stones have been evacuated, a tube usually is inserted into the duct
for drainage of bile until edema subsides.
This tube is connected to gravity drainage tubing.