Laparoscopic Cholecystectomy Answers Patient Questions

The gallbladder is a cystic organ that stores and concentrates bile in the body and is long and pear-shaped, 8-12 cm long and 3-5 cm wide, with a capacity of about 40-60 ml. Bile is produced by the liver as a digestive fluid and is sent to the small intestine to help digest fat in food. The excess bile produced by the liver is temporarily stored in the gallbladder, and when food enters the small intestine, the muscle wall of the gallbladder contracts, allowing the bile to flow down the bile duct into the small intestine. Patients with gallbladder diseases such as cholecystitis, gallbladder stones or gallbladder polyps often feel vague pain in the right upper abdomen, sometimes with sudden onset of colic and radiation to the back of the shoulder, which seriously affects their daily life. If the stone falls into the common bile duct, it may lead to secondary bile duct stones or biliary pancreatitis, and if the stone is embedded in the gallbladder neck, it may lead to pus accumulation or perforation of the gallbladder, which may be life-threatening in serious cases. In addition, gallbladder polyps or stones repeatedly stimulate the gallbladder wall, which may induce gallbladder carcinoma, which is extremely malignant and has a very poor prognosis. Therefore, gallbladder disease should be treated as early as possible. Only surgical removal of gallbladder can achieve the purpose of radical cure. The traditional open surgery is very traumatic, painful and slow in recovery, and may also leave a lot of sequelae. The introduction of laparoscopic cholecystectomy has brought a boon to patients with gallbladder diseases. The laparoscopic liver, gallbladder, pancreas and spleen surgery has been carried out skillfully since the establishment of our department. Laparoscopic cholecystectomy is less traumatic, less painful, faster recovery and shorter hospital stay, which is incomparable to traditional open cholecystectomy. Combined with the high level of rapid intraoperative cryopathology in the Cancer Hospital of Fudan University, more and more gallbladder patients choose to undergo gallbladder surgery in our department. Regarding several questions raised by patients, I would like to answer the following questions: 1. A: The main indications for laparoscopic cholecystectomy are different types of gallbladder stones with obvious clinical symptoms, gallbladder polyp-like lesions, and asymptomatic simple gallbladder stones. In addition, patients with diabetes mellitus combined with gallbladder stones should be treated surgically as soon as clinical symptoms appear. The main contraindications are acute obstructive purulent cholangitis, acute necrotizing pancreatitis, gallbladder stones combined with severe intra-abdominal infection, patients with severe high-risk gallbladder stones, gallbladder stones combined with severe cardiac and pulmonary insufficiency, in addition, patients with severe cirrhosis, portal hypertension, previous history of major upper abdominal surgery, etc. should not do this treatment. 2.What should patients pay attention to after surgery? A: After surgery, there may be transient nausea or vomiting due to the effect of anesthetics, which can be treated with targeted medication under the guidance of doctors. You can eat liquid food such as water, rice soup, thin porridge, etc. on the next day of surgery, but milk should be held off. Most of the surgical wounds are not in serious pain. If the pain is obvious, you can tell the doctor and use painkillers under the guidance of the doctor. The wound can usually be removed in 4~5 days. 3.Are there any health effects after gallbladder removal? A: The fatty food people eat depends on bile to help digestion, and the role of the gallbladder is to store and concentrate bile, and it is a container. After the gallbladder is removed, the role of the gallbladder as a container will be replaced by the common bile duct, so the removal of the gallbladder will not affect health, and after a short period of adaptation, you can live like normal people. 4.Will the laparoscopic surgery leave conspicuous incision scars? A: No! Usually after open surgery, the abdominal wall often leaves a long scar, which is detrimental to the beauty and may bring inconvenience to life and work. When laparoscopic surgery is done, 2-3 puncture holes in the abdominal wall can be sewn with 1-2 stitches, so there is no conspicuous incision scar at all, and two or three months after surgery, there is almost no trace of wound on the abdominal wall. 5.How fast is the recovery after laparoscopic surgery? A: Very short time! Generally, you can get out of bed in 6-8 hours after the operation, and you can eat liquid on the first day after the operation. After proper infusion and anti-inflammatory treatment, you can be discharged from the hospital on the second day after surgery.