Introduction to Cholecystectomy (Nursing)

by Rhonda Lawes, PhD, RN

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    00:00 Hi, welcome to our series on the gallbladder.

    00:03 In this one, I'm gonna teach you what you need to know about taking care of a patient after gallbladder removal surgery.

    00:11 So, have you ever wondered? Can you live without your gallbladder? Like, is that okay? Yeah, having a gallbladder is convenient, but it's actually not essential to life.

    00:22 So, bile is created in between meals, about half of it is stored in the gallbladder and half of it flows on down to the small intestine.

    00:31 So, keep those numbers kind of in your mind.

    00:33 So, in between meals, the bile that's created, half of it goes to the gallbladder, the other half of it flows on down to the intestine.

    00:42 After removal of the gallbladder, the bile just flows right on directly into the small intestine.

    00:50 So, look at the left, right? You see a patient with a gallbladder.

    00:54 On the right, we've got a patient without a gallbladder.

    00:58 So, everything is flowing right into the small intestine.

    01:02 So, why do you think a patient would need a cholecystectomy? Well, if you'll look at that big circle that will give you a clue, right? Again, that's what we call an angry gallbladder.

    01:14 So, a patient needs a cholecystectomy, a removal of the gallbladder.

    01:19 Now, symptomatic gallbladder dysfunction, what you're looking for is they have recurrent biliary colic.

    01:24 That pain from the spasms, they've got chronic cholecystitis, they have an acute cholecystitis, meaning that gallbladder is infected, or the worst case scenario, they have a gangrenous cholecystitis.

    01:39 So, I've given you four options here. Why do we have a gallbladder removed? Well, they keep having these periods of pain. It's just not great for life quality.

    01:50 They have chronic cholecystitis or they've got an acute episode right now or that gallbladder's become gangrenous and can be life-threatening.

    02:01 So, why don't we just break up the stones? Why do we have to do this whole surgery thing? Well, the body's just gonna keep on making more stones and the patient will be in the same situation again.

    02:13 So, it's not like a kidney stone. This is different.

    02:17 You're just gonna keep making more and more and more stones and this is going to develop into an ongoing and chronic problem.

    02:24 Now, what does a patient need to know before they have a cholecystectomy? What are the things they should consider? Well, the things the patient should consider are the things you, as a nurse, should be aware of so you can be on the lookout for them.

    02:39 So, after a cholecystectomy, we know the patient is at risk for bleeding.

    02:43 They're at risk for infections. They might have some type of injury during the procedure.

    02:48 It happens. Everybody's body is different.

    02:52 It doesn't mean the surgeon wasn't extremely careful, it's just a risk of having any surgical procedure.

    02:58 Now, the greater risk is if the patient has really severe disease and lots of scarring.

    03:04 So, the longer this is going on, the more chronic it is, the more scarring it is, the higher the risk is for them to have complications after surgery.

    03:12 Now, you can have bile duct injury. We're talking about the common bile duct.

    03:17 There's a very small chance, but then the patient is gonna have to have an open 'chole' to repair that.

    03:23 So, when I say very small chance, look at that statistic right there.

    03:28 0.5% chance, but you know before a patient has a surgical procedure, they need to know what all the possible risks are.

    03:38 So, even if a patient is trying to do a laparoscopic chole, if there's an injury to the bile duct, they may end up having open surgery to repair that.

    About the Lecture

    The lecture Introduction to Cholecystectomy (Nursing) by Rhonda Lawes, PhD, RN is from the course Gallstones and Cholecystitis: Treatment (Nursing).

    Included Quiz Questions

    1. Gallbladder
    2. Liver
    3. Large intestine
    4. Pancreas
    1. Bleeding
    2. Infection
    3. Bile duct injury
    4. Cholecystitis
    5. Intestinal rupture

    Author of lecture Introduction to Cholecystectomy (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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