(Disclaimer: This article is for scientific use only, and relevant information in the following content has been processed to protect patient privacy)
Abstract: The patient in this case is a middle-aged male who presented with uncomfortable symptoms such as abdominal distension after dinner, loss of appetite, and smaller food intake a month before the consultation, but did not seek medical attention. However, the symptoms worsened recently, so he went to our hospital and was diagnosed with gallbladder obstruction after relevant examinations, and underwent laparoscopic cholecystectomy. He recovered well after the operation without postoperative complications and was discharged after 3 days of hospitalization.
Basic information】Male, 45 years old
Disease Type】Gallbladder obstruction
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Date of consultation】August 2021
Treatment plan】Surgical treatment (laparoscopic partial cholecystectomy) + intravenous infusion (ceftazidime for injection)
Treatment period】3 days in hospital
Effectiveness】Cured, abdominal distension and loss of appetite disappeared
I. Initial consultation
The patient was a 45-year-old male, smoker for more than 10 years, with irregular diet and mainly take-out. He came to the clinic in August 2021, complaining of abdominal distension without obvious causes in the past month, mainly upper abdominal distension, which was aggravated after dinner, and decreased appetite and eating volume compared with one month, but he did not pay attention to it at the beginning of the illness, so no special treatment was given. However, the symptoms of discomfort have not improved so far, and the quality of daily life has been affected by the disease, which affects the diet and sleep in general, so he came to our hospital for diagnosis and treatment.
II. Treatment process
After the patient was admitted to the hospital, routine blood and abdominal ultrasound examinations were performed to identify the cause of the disease, suggesting thickening of the gallbladder wall and nodular high-density foci with clear borders at the neck and bottom of the gallbladder, suggesting the presence of gallbladder obstruction, combined with gallbladder stones and cholecystitis, which is also the cause of the patient’s abdominal distension. At the same time, the patient and his family were informed of his current condition and surgery was recommended. At first, when he heard about surgery, the patient looked difficult and was afraid that the recovery time after surgery would be too long and affect his work. However, after explaining to the patient that laparoscopic partial cholecystectomy with faster postoperative recovery was also an option, the patient readily agreed. So preoperative examination was performed, and after excluding contraindications to surgery, the patient was operated on and the gallbladder was removed. After the operation, the patient was sent back to the ward and given ceftazidime for injection intravenously to prevent postoperative infection.
III. Treatment effect
The patient returned to the ward safely after surgery, and his vital signs were stable. After 3 days of hospitalization, the patient had initially recovered, complained of the disappearance of abdominal distension and normal appetite, and found that no infection occurred during the use of antibiotics, so the patient’s request for discharge was agreed. One month after the operation, the patient followed up in the outpatient clinic and reported that the discomfort disappeared and that the incision had now fully recovered, and his daily work was not affected. This indicates that the operation was more successful and the disease has been cured.
IV. Precautions
Although the patient’s surgery went well, he still needs to pay attention to proper postoperative care. The family should help the patient to wash and wipe the body, and avoid wetting the incision dressing to avoid inducing postoperative infection; in addition, the drainage tube in the abdomen should be kept unobstructed to avoid its bending and folding, especially when turning, sitting or lying down, the position of the drainage tube should be paid more attention to avoid its accidental dislodgement. After 3 days of hospitalization, the patient had initially recovered and was recommended to be discharged home for recuperation. The patient was very happy to learn this, and I was also glad that the patient’s condition had improved. The patient was very happy to learn about it, and I was also glad that the patient’s condition had improved. I also told the patient that he should not do heavy physical work during the recuperation period at home, but he could do exercises such as walking and tai chi, and the intensity of the exercises should be suitable for not feeling tired, which could help his body recover.
V. Personal insight
For the patient in this case, gallbladder obstruction is more related to poor daily dietary habits, because the diet is more oily and irregular, which can affect the normal secretion of bile and thus increase the chance of gallbladder obstruction. Therefore, to prevent gallbladder obstruction, the first thing we should do is to improve our dietary habits, make sure that the three meals are regular and quantitative, with balanced nutrition, avoid eating too greasy food for a long time, and increase the intake of fresh vegetables and fruits appropriately.