Laparoscopic Cholecystectomy: Recovery and Risks (Nursing)

by Prof. Lawes

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    00:00 Now, let's talk about recovery. So, I've got a timeline there for you.

    00:04 We've got from the first day all the way up to about four weeks.

    00:08 That's a frame of reference I want you to give your patients.

    00:10 So, if they have to be in-patient, sometimes you have to with a gallbladder, in-patient observation, 1-2 days for acute episodes.

    00:19 That may be something they just want to keep an eye on the patient after surgery.

    00:23 Some people go home right away.

    00:26 So, some patients may have to be in-patient for observation, other patients can be discharged even on the same day.

    00:33 Now, if it's an out-patient complete schedule, the patient doesn't have any complications, they don't have infection, they may do it completely out-patient.

    00:41 So, the patient may be in the hospital before or after the procedure or it may be completely out-patient, meaning you get out of your own bed, go to the hospital, have the procedure, you're recovered, and you go back home and stay in your own bed that night.

    00:56 It just depends on what's going on with the patient.

    00:59 Now, next up, I want you to know it's gonna take about 2-3 days for them to feel much better.

    01:05 Now, they'll feel back to their normal selves at about 7 days or a week.

    01:09 Okay, so look at that. Those first days after surgery, you're kind of rough.

    01:13 Now, I'm still talking about a laparoscopic procedure.

    01:17 Yeah, so you think like you just be able to bounce right back out of bed.

    01:20 No, it's a pretty big deal.

    01:22 You've taken a hit in your GI tract and it takes your body time to recover from that.

    01:27 So, you want the patient to plan. Hey, it's gonna be a couple days where you're gonna do a lot of sleeping, resting, just recovering, and it'll be up to a week before you start to feel much like your old self again.

    01:39 The first 2-3 days are the roughest, after that, it gets a lot easier.

    01:44 Now, for 4 weeks, I'm talking about for the first 4 weeks after the procedure, there are restrictions.

    01:50 Because you've had scopes through that abdominal wall, you have lifting restrictions.

    01:54 So, you want to make sure the patient knows they shouldn't lift anything over 20 pounds for approximately 4 weeks.

    02:01 That includes children, grocery bags, whatever it is, nothing over 20 pounds.

    02:07 There's one more important thing I want to talk to you about.

    02:11 What a patient experiences after a laparoscopic procedure.

    02:15 Now, abdominal bloating can happen both with laparoscopic and with an open chole, but let me help you understand what a laparoscopic patient goes through.

    02:25 See, during the procedure, CO2 gas is used to inflate the abdomen during the procedure.

    02:31 So, yeah, that's exactly what you're picturing.

    02:34 We're blowing up that patient like a float in the Macy's Thanksgiving Day Parade.

    02:38 The reason they do that is they need to have plenty of room to visualize for safety.

    02:44 Now, generally, most of the carbon dioxide gas used during the procedure is removed at the end of the surgery.

    02:51 However, here's the caveat.

    02:54 There can sometimes be small amounts of gas under the diaphragm.

    02:58 Now, you wouldn't think small amounts of this gas would be a problem, but they really can be for some patients.

    03:04 They particularly cause right shoulder pain.

    03:07 Not something you would expect from having your gallbladder removed, but it can be fairly common for certain patients.

    03:13 Nothing to be alarmed about, but it does need to be addressed, because it's uncomfortable for your patients.

    03:20 Now, most of this small residual gas is gone in about 24 hours or less, but what do you think the best remedy for this gas is? Yeah, what the patient is not gonna feel like doing. Walking, moving, being active.

    03:33 That will help the body reabsorb that gas.

    03:37 So, keeping moving after a surgery procedure is always good advice.

    03:42 Now, we've got one more bullet point for you there.

    03:44 Abdominal bloating feeling after a surgery can last a few days for an open chole.

    03:49 So, any time you go in and mess with my GI tract, my GI tract kinda takes a little bit to readjust.

    03:56 That is normal. So, you may have a certain type of abdominal bloating with both laparoscopic mostly from the air or you may have abdominal bloating feeling after an open chole.

    04:07 Keep those both in mind. They're expected.

    04:10 Just help your patient with strategies to deal with it.

    04:13 Now, this may seem like an obvious question to you.

    04:16 Can you still have gallbladder attacks after surgery? Well, if the gallbladder's removed, how could that happen? Well, the answer actually is yes, you can still have a gallbladder attack after surgery, but thankfully, it doesn't happen that often. Well, tell that to my sister. It happened to her.

    04:35 She had the laparoscopic chole and then she had a major gallbladder attack while she was trying to recover. Why? Well, there is one stone left in the ducts.

    04:46 So, it does not happen very often, but again, my sister doesn't really care about those odds because it happened to her.

    04:53 So, a patient may have a gallbladder attack after surgery.

    About the Lecture

    The lecture Laparoscopic Cholecystectomy: Recovery and Risks (Nursing) by Prof. Lawes is from the course Gallstones and Cholecystitis: Treatment (Nursing).

    Included Quiz Questions

    1. 1 week
    2. 4 days
    3. 2 weeks
    4. 48 hours
    1. 20 pounds
    2. 5 pounds
    3. 10 pounds
    4. 15 pounds

    Author of lecture Laparoscopic Cholecystectomy: Recovery and Risks (Nursing)

     Prof. Lawes

    Prof. Lawes

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