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Abstract: This is a 48-year-old middle-aged woman with a history of chronic cholecystitis for many years and chronic right upper abdominal pain, which was treated symptomatically with self-administered medications, but the symptoms always recurred. Recently, the patient’s right upper abdominal discomfort worsened and she came to the clinic and found that gallbladder stones and some thickening of the gallbladder wall had developed due to long-term inflammatory stimulation. In order to seek complete treatment and avoid the re-development of the disease, the patient underwent surgery. Three days after the operation, the patient’s pain and discomfort disappeared and she was discharged successfully.
Basic information】Female, 48 years old
Disease Type】Chronic cholecystitis
Hospital】Liaocheng People’s Hospital
Consultation time】November 2021
Treatment plan】Laparoscopic cholecystectomy
Treatment Period】3 days of hospitalization
Effectiveness】Discomfort in the right upper abdomen disappeared and she was discharged successfully.
I. Initial consultation
The patient is a 48-year-old middle-aged woman who reported chronic cholecystitis symptoms for many years and constant discomfort in the right upper abdomen. Recently, the discomfort in the right upper abdomen was worse than before, and the effect was worse after taking anti-inflammatory and biliary tablets, so she came to our hospital to seek further treatment. The patient’s routine examination and abdominal ultrasound examination showed that the patient had chronic cholecystitis combined with gallbladder stones and gallbladder wall thickening. We explained to the patient that the formation of gallbladder stones was related to his long-term chronic cholecystitis, and that if left untreated, it could lead to acute cholecystitis and even induce gallbladder malignancy, so he needed to undergo surgery to remove the gallbladder through laparoscopic operation. After the patient agreed to this plan, he was admitted to the hospital for further treatment.
II. Treatment history
After admission, the patient was actively provided with routine blood tests, liver and kidney function tests, virus screening, and electrocardiogram, etc. The results showed no obvious contraindications to surgery, so preoperative preparation was actively performed. After cholecystectomy, the gallbladder was dissected and visible stones were present, but no obvious tumor growth was seen. Postoperative pathological tests were sent, and the results also confirmed chronic cholecystitis.
III. Treatment results
The patient’s surgery was minimally invasive because it was performed laparoscopically, and the procedure was smooth and less invasive. On the third day of hospitalization, the patient’s incisional pain had been relieved to a large extent and he resumed basic activities, and his right upper abdominal pain disappeared completely.
IV. Notes
We are glad that the patient’s symptoms of right upper abdominal pain have been controlled and her condition has improved significantly after aggressive surgical treatment. However, since the patient was not completely cured at the time of discharge, the following conditions still need to be noted in daily life.
1, patients in the first 3 months after discharge, daily should pay attention to a light diet, avoid eating spicy, stimulating, greasy food, mainly because after the patient’s gallbladder removal, the early stage may lead to diarrhea due to excessive bile excretion, which requires a longer time to recover, so during this period, should try to avoid the intake of stimulating food.
2. Although the pain is no longer obvious when the patient is discharged from the hospital, the sutures at the incision are not removed, so the sutures should be removed at the local hospital 7 days after surgery.
3. Patients should pay attention to follow the doctor’s prescription for review in the early postoperative period, and should return to the hospital for a review once a month after surgery, including routine blood tests, liver and kidney function tests, and abdominal ultrasound. If no obvious abnormality is found in this review, regular physical examination will be sufficient thereafter.
V. Personal insight
With the accelerated pace of life and changes in dietary structure, the incidence of chronic cholecystitis is becoming more and more prevalent and younger. If there is discomfort in the right upper abdomen, and the symptoms are aggravated after a full or fatty diet, you should go to the hospital promptly and try to avoid self-medication for early detection and early treatment. The patient in this article was treated only symptomatically after the onset of discomfort and did not pay attention to the recurrence of the disease, which led to further aggravation of the disease and the appearance of other symptoms such as gallbladder stones and gallbladder wall thickening, and eventually had to be treated by cholecystectomy to avoid inducing more serious diseases. This shows that early diagnosis and thorough treatment are especially important for the development and control of the disease.