Treatment of cholecystitis with laparoscopic surgery

The article is expertly consulted by MSc Duong Xuan Loc - Gastroenterologist - General Surgery Department - Vinmec Danang International General Hospital.

Cholecystitis is an infection of the gallbladder. If left untreated, this condition can lead to infection and perforation of the gallbladder. Because of its dangerous nature, in many cases, cholecystitis requires urgent treatment to avoid unfortunate consequences.

To treat acute cholecystitis, there are two main methods applied based on the stage of disease presentation.
1.1 Medical treatment of cholecystitis Apply when the disease is in stage 1 and 2
The patient is assigned to fast and insert a nasogastric tube. Transfusion to the patient. Use of parasympathomimetic drugs to block the X-nerve and antisecretory drugs. Monitor patients based on: white blood cell count every six hours, temperature every two hours, abdominal examination every two to three hours No antibiotics were used in the patient. Arrange surgery when the patient is pain free.

1.2 Surgical treatment Apply to patients with cholecystitis in stages 3 and 4. Surgery can be performed for patients with the use of broad-spectrum antibiotics. There are two surgical methods currently performed:
Programmatic surgery
Gallbladder drainage, then elective surgery with elderly, frail, severely debilitated, toxic patients with chronic comorbidities such as: diabetes, tuberculosis, cardiovascular disease.
Treatment of cholecystitis by laparoscopic cholecystectomy
This is a method widely applied today, shortening treatment time, reducing postoperative pain and safety. If the doctor suspects a common bile duct stone, an intraoperative contrast-enhanced cholangiogram may be performed.
Laparoscopic cholecystectomy procedure:
Patient is under endotracheal anesthesia, lying on his back The main surgeon stands on the patient's left side at the level of the umbilicus Enter the abdomen by closed or open method according to the incision 1cm above or below the navel placed camera, maintain CO2 pressure pump (less than 15mm Hg). Placing more trocars under camera surveillance ensures the most favorable principle for surgery, (usually 2 more trocars are placed below the sternal breast and below the right flank) Using non-traumatic instruments to reveal the gallbladder Anatomy expose the cystic duct and cystic artery. Gallbladder neck duct and cystic artery are treated with clips or sutures Cut the gallbladder out of the gallbladder bed with a unipolar electrocautery For difficult-to-identify the gallbladder neck canal can proceed to cystectomy anterior biliary tract with a unipolar knife and then ligation, cut the cystic artery and posterior cystic duct Carefully examine the cystic duct, gallbladder bed, common bile duct and cystic artery Wipe the abdominal cavity, remove the gallbladder with a plastic bag Remove all the CO2 and close the trocar holes.

The advantages of laparoscopic cholecystectomy for cholecystitis include:
Less invasive laparoscopic surgery, the small incision is only about 0.3 - 1cm, so it causes less pain, high aesthetics; Quick surgery time, only about 15 - 30 minutes; High safety and effectiveness of treatment; Patients do not have to lie motionless in bed for a long time, the recovery time after surgery is quick, helping patients feel comfortable and reducing treatment costs. To effectively treat cholecystitis through laparoscopic cholecystectomy, patients need to choose a reputable medical facility with full equipment and a team of good doctors. Currently, all hospitals under Vinmec Health System apply modern laparoscopic cholecystectomy technique in the treatment of gallbladder diseases today. Patients should choose Vinmec thanks to the following advantages:
Vinmec owns a system of modern equipment, advanced medical machinery, maximum support for the surgical process; Modern facilities, aseptic environment ensure patient safety, limit complications; A team of highly qualified medical professionals, well-trained at home and abroad, seasoned with experience, able to improvise and promptly handle unusual problems; Patients are cared for and closely monitored after surgery, rested to recuperate in a standard and fully equipped ward. Master. Doctor Duong Xuan Loc has more than 12 years of experience as a Gastroenterologist and is currently a Gastroenterologist at the Department of General Surgery - Vinmec Danang International General Hospital.