Preoperative Care
Because gallbladder surgery is performed under general anesthesia, the stomach must be completely empty. This precaution is taken to avoid vomiting during and after surgery. Nothing may be taken by mouth after midnight, and smoking is prohibited.
Blood "thinning" medication, including aspirin, must be discontinued several days before the operation to avoid excessive bleeding during the procedure. The discontinuation of any medication must be discussed with the doctor when the surgery is scheduled.
Preoperative tests are usually ordered and completed a few days before the surgery. Depending on the patient's health, these may include blood tests, a chest x-ray, an EKG, and a urinalysis. If these were done during the initial workup and diagnosis, they usually are not repeated.
Patients check in to the hospital the day of the surgery. Inpatients are checked into a regular hospital room. Most patients undergoing the laparoscopic procedure are not checked into a room; instead they go to the outpatient surgery area.
On admission to the hospital, an informed consent form acknowledging that the patient understands the procedure, the risks, and that they will be receiving anesthesia and possibly other medications must be signed.
The anesthesiologist (doctor who administers the anesthesia) speaks with the patient prior to surgery and performs a brief physical assessment. The anesthesiologist must be aware of all drugs that the patient uses on a regular basis, any history of allergies, and previous adverse reactions to anesthesia. This is to assess possible conditions or problems that may influence the choice and dosage of anesthesia and to determine what, if any, special precautions need to be taken.
The patient is then taken to the preoperative or holding area and remains in bed except to use the bathroom. An intravenous (IV) is started for fluids and medication. Patients may have had the IV started in their room. Sedation is given through the IV or by injection. The anesthesia is administered in the operating room.
Postoperative Care
Patients are taken to the postanesthesia care unit (PACU) to recover from the anesthesia. They are closely monitored by the PACU nursing staff and remain there until the anesthesia wears off.
Laparoscopic Surgery
Recovery from the laparoscopic procedure is quicker than from the open procedure. As the anesthesia wears off, and once vital signs stabilize, the nurse offers the patient ice chips. If ice is tolerated, water and other clear liquids are offered. Once liquids are tolerated, patients can eat a light meal and the IV is removed.
Sometimes patients are nauseated after waking from the anesthesia. This sensation usually passes. If it does not, medication can be given to relieve it.
Postoperative pain can usually be controlled with over-the-counter pain relievers. Some patients may need a stronger, prescription analgesic.
The incisions are covered by small a...
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