• long and short term outcomes.
• post-operative expectations. .
• the role of theatre team (scrub/scout and anaesthetic) and,.
• the role of the recovery team (PACU).
Briefly define the topic:.
A laparoscopic cholecystectomy with intraoperative cholangiogram is a procedure performed on patients who suffer acute and chronic inflammation of the gallbladder. This can either mean they suffer from cholecystitis, inflammation of the gallbladder, or cholelithiasis the formation of stones in the gallbladder. It is when gallstones become lodged in the cystic duct creating an obstruction, resulting in bile being unable to flow in and out of the gallbladder that inflammation occurs (McCance K & Huether 2006 p. 1427). An intraoperative cholangiogram serves the purpose of visualising, exploring and checking for patency in the common bile duct and near by hepatic ductal branches, making sure there are no stones blocking the flow of bile in the biliary tract. The bilary tract consists of ducts that link and carry bile from the liver and the pancreas to the gallbladder, from the gallbladder to the duodenum, where bile begins the process of helping break down and digest food. (Rothrock 2011, p. 371-372). The biliary ducts include, the hepatic duct, common bile duct, pancreatic duct and the cystic duct (National Digestive Diseases Information Clearinghouse 2013).
The gall bladder is situated in a shallow bed underneath or on the backside of the liver, with the fundus of the gallbladder being easily seen when viewed laparoscopically. The gallbladder is the organ that stores concentrated bile, which has been made by the liver and that is not immediately required for digestion (Marieb & Hoehn 2007, p.916). Bile is a yellowish green fluid made in the liver containing bile salts, cholesterol, electrolytes, water and bilirubin, which is a pigment. (This will help explain complications of surgery.
