Laparoscopic cholecystectomy
Laparoscopic Cystectomy (LC) Wang Xiankui, Department of Hepatobiliary and Pancreatic Surgery, Sichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital
Introduction
Laparoscopic cholecystectomy, known as minimally invasive surgery, is performed in vivo through a tiny incision in the abdominal wall using minimally invasive instruments, an endoscope, intra-abdominal illumination and an electronic camera system.
Gallbladder morphology and function
The main function of the gallbladder is to store and concentrate the bile synthesized by the liver. Bile enters the gallbladder during fasting, and when the gallbladder contracts during feeding, the bile enters the intestine through the cystic duct and common bile duct.
What are the common gallbladder diseases?
Common gallbladder diseases include: gallbladder stones and chronic cholecystitis, acute cholecystitis, gallbladder polyps and adenomyosis, etc. Patients with gallbladder diseases should have a daily diet should be based on light, easy-to-digest food, drink more water (1500-2000ml), eat easy-to-digest protein, should not overeat, avoid eating animal offal, egg yolk, fried food, spicy and stimulating food, etc. When you feel discomfort or stuffy pain in the heart fossa after over-eating fatty food, or paroxysmal colic in the right upper abdomen with or without radiation from the right scapula, along with nausea, vomiting, fever and other symptoms, you need to be alert to the existence of gallbladder disease and not to confuse it with stomach disease and delay treatment. Long-term chronic cholecystitis can cause severe inflammation and adhesions, pus in the gallbladder, gallbladder perforation, and even gallbladder malignancy, as well as heart, lung, or other tissue and organ comorbidities.
Advantages of laparoscopic cholecystectomy
1.Little surgical trauma, fast postoperative recovery, light pain, and can get out of bed and eat 6 hours after surgery.
2.The intraoperative exploration is extensive and can see the abdominal lesions that cannot be seen during traditional open abdomen, and the anatomical structure is clearly observed during the operation, which is not easy to damage the surrounding organs and bile duct.
3.The risk of postoperative incisional infection is almost 0, the possibility of pulmonary infection is greatly reduced, abdominal adhesions are significantly reduced, and the risk of postoperative adhesive intestinal obstruction is greatly reduced.
When it is recommended to remove gallbladder
1, those with typical clinical manifestations of gallbladder stone attacks, auxiliary examinations to determine gallbladder stones, filled gallbladder stones or porcelain gallbladder, with a higher chance of malignant transformation.
2, acute purulent, gangrenous, hemorrhagic and perforated cholecystitis.
3, recurrent episodes of chronic cholecystitis, ineffective by conservative treatment.
4, solitary gallbladder polyps, >1.0 cm in diameter, with a large base, progressive growth, abundant blood flow, thickened gallbladder wall at the attachment site, and attachment to the liver bed surface.
5, magnetized gallbladder, gallbladder adenomyosis.
Early diet after laparoscopic cholecystectomy
For at least 15 days after surgery, patients should avoid fried foods (French fries, fried meat, etc.), sweets (cake, chocolate, cream, etc.), and high cholesterol foods (eggs, liver and shrimp, etc.), after which they can gradually return to their previous diet, but it is recommended that patients should focus on soft foods in their daily diet, reduce the intake of calories and fine carbohydrates, and reduce fat and cholesterol intake along with more Dietary fiber should be consumed.
Post-discharge habits
After laparoscopic cholecystectomy, in addition to continuing medication and regular checkups as prescribed by the doctor, the following matters need to be noted in life and diet.
1, should abstain from smoking, alcohol, coffee, strong tea, carbonated beverages, sour and spicy food and other stimulating foods.
2, to chew slowly, eat light and easy to digest food, avoid full, hard food.
3, fat intake should be limited, especially not too much animal fat at a time.
4, avoid too cold food, it is recommended to eat less and more meals, and not too much exercise after meals.
5, have a regular life, to ensure adequate rest and sleep, and exercise regularly.
Food types
Allowed to eat
Prohibited/reduced
Staple food
Fine rice and noodles
Coarse grains, puffed and fried staple foods
Dairy products
Skim or low-fat milk or yogurt
Full-fat milk or chocolate milk
Eggs
Egg whites, up to 1 per day
Egg yolks, fried eggs
Beverages
Clear water, light tea
Alcoholic beverages, coffee, strong tea
Meat
Skinless poultry, fish and lean meat (pork, beef, sheep, etc., cut off fat)
Fatty meat, animal offal, fish roe, crab roe, shrimp head, bacon, salted meat, canned meat, etc.
Vegetables
Low-fiber vegetables, such as peeled winter squash, potatoes, eggplant, cucumbers, tomatoes, etc.
High-fiber vegetables, such as leeks, celery, beans, etc.
Fruits
Medium or low sugar fruits (such as watermelon, apple, kiwi, strawberry, etc.), purees and juices
Fruits with high sugar content (e.g. lychee, grapes, oranges, sugar cane, bananas, etc.)
Sweet food
Light honey water, lotus root powder
Excess cane sugar, sweets, chocolate
Edible oils
Peanut oil, olive oil, soybean oil, tea oil and other vegetable oils, total 10-15 g per day
Animal oils, margarine and various types of trans fatty acid foods
Others
Ketchup, garlic, vinegar, unbuttered popcorn
Fatty foods such as olives, peppers and cream (e.g. cakes)
Cooking methods
Steaming, stewing, etc.
Frying, deep-frying, etc.
Gallbladder disease prevention
1.The most important point to prevent gallbladder disease is to eat breakfast.
2, usually drink more water; eat less sweets and avoid gaining weight, fat metabolism, overweight and gaining weight are all related to the formation of gallstones.
3, healthy diet, balanced diet, avoid eating a lot of fried food, animal food containing high cholesterol, such as egg yolk, animal offal, stimulating food, spicy food, etc.
Outpatient review
We recommend that you have your first follow-up examination 2 weeks to 1 month after surgery. The doctor will recommend blood tests, abdominal ultrasound, etc. according to your actual condition during the outpatient consultation.