Materiały źródłowe

• #1 Cholecystitis and Cholelithiasis | Diseases and Disorders

  https://nursing.unboundmedicine.com/nursingcentral/view/Diseases-and-Disorders/73556/all/Cholecystitis_and_Cholelithiasis

  Cholecystitis is an inflammation of the gallbladder wall; it may be either acute or chronic. […] It is almost always associated with cholelithiasis, or gallstones, which most commonly lodge in the cystic duct and cause obstruction. […] Silent gallstones may also occur and are so common that most people may have them at some time. […] Only stones that are symptomatic require treatment. […] In developed countries, the prevalence is 10% to 20%, and in the United States, approximately 20 million people have gallstones. […] Cholecystectomy is the most common major surgical procedure performed by general surgeons in the United States. […] Gallstones are most commonly made of either cholesterol or bilirubin and calcium. […] If gallstones obstruct the neck of the gallbladder or the cystic duct, the gallbladder can become infected with bacteria such as Escherichia coli.

• #1 Gallstones (Cholelithiasis): Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/7313-gallstones

  Gallstones (cholelithiasis) are hardened pieces of bile that form in your gallbladder or bile ducts. Theyre common, especially in females. Gallstones dont always cause problems, but they can if they get stuck in your biliary tract and block your bile flow. If your gallstones cause you symptoms, youll need treatment to remove them typically, surgery. […] Gallstones generally dont cause symptoms unless they get stuck and create a blockage. This blockage causes symptoms, most commonly upper abdominal pain and nausea. […] Typical gallstone pain is sudden and severe and may make you sick to your stomach. This is called a gallstone attack or gallbladder attack. […] Gallbladder removal (cholecystectomy) is the only reliable long-term solution for gallstones. Its one of the most common procedures performed worldwide, usually as a laparoscopic surgery.

• #1 Gallstones – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214

  Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that’s released into your small intestine. […] People who experience symptoms from their gallstones usually require gallbladder removal surgery. Gallstones that don’t cause any signs and symptoms typically don’t need treatment. […] Make an appointment with your doctor if you have any signs or symptoms that worry you. […] Seek immediate care if you develop signs and symptoms of a serious gallstone complication, such as: Abdominal pain so intense that you can’t sit still or find a comfortable position. […] A gallstone that becomes lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever.

• #1 4 Cholecystitis and Cholelithiasis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cholecystitis-cholelithiasis-nursing-care-plans/

  Cholecystitis is the inflammation of the gallbladder, usually associated with gallstones impacted in the cystic duct. […] Nursing care planning and management for patients with cholecystitis include relieving pain and promoting rest, maintaining fluid and electrolyte balance, preventing complications, and provision of information about the disease process, prognosis, and treatment. […] Patients with cholecystitis and cholelithiasis are at risk for deficient fluid volume due to excessive losses resulting from vomiting or diarrhea, limited intake due to nausea and anorexia, and altered clotting processes due to liver dysfunction. […] The client will demonstrate adequate fluid balance evidenced by stable vital signs, moist mucous membranes, good skin turgor, capillary refill, individually appropriate urinary output, and absence of vomiting.

• #1 Nursing Care for Cholelithiasis – Made For Medical

  https://www.madeformedical.com/nursing-care-for-cholelithiasis-comprehensive-guide-for-effective-management/

  Cholelithiasis, commonly known as gallstones, is a prevalent condition affecting millions worldwide. As a nurse, it is crucial to understand the comprehensive nursing care required for patients with cholelithiasis. […] When assessing a patient with cholelithiasis, it is essential to gather relevant information to develop an accurate care plan. […] Obtain the patients medical history, including any previous episodes of gallstone-related complications, previous surgeries, or underlying medical conditions such as diabetes or liver disease. […] Assess the patient for common symptoms associated with cholelithiases, such as abdominal pain (especially after fatty meals), nausea, vomiting, bloating, and jaundice. […] Perform a thorough physical examination, focusing on abdominal tenderness, palpable gallbladder, jaundice, and signs of complications such as fever or infection.

• #1 Nursing care plan for acute cholecystitis

  https://nursipedia.com/nursing-care-plan-acute-cholecystitis/

  Acute Cholecystitis is an inflammation of the gallbladder, usually caused by a blockage of the gallbladder or bile ducts by gallstones. Nursing care plan for Acute Cholecystitis is focused on providing relief to the patient from the associated pain and preventing future complications. […] Pain related to obstruction of the common bile duct by gallstones. […] Risk of infection related to inflammation of the gallbladder. […] Nausea and vomiting related to increasing inflammation. […] The patient will demonstrate reduced pain with decreased need for analgesic medications; improved fluid and electrolyte balance; will present with no signs of infection; and have improved nutrition through oral intake. […] Pain management is important to reduce the pain experienced by the patient and to improve comfort.

• #1 Cholecystitis Nursing Care Management and Study Guide

  https://nurseslabs.com/cholecystitis/

  Cholecystitis is the acute or chronic inflammation of the gallbladder. […] Management of cholecystitis include the following: […] The major goals for the patient include: Relieve pain and promote rest. Maintain fluid and electrolyte balance. Prevent complications. Provide information about disease process, prognosis, and treatment needs. […] Treatment of cholecystitis depends on the severity of the condition and the presence or absence of complications. […] Expected patient outcomes are: Pain relieved. Homeostasis achieved. Complications prevented/minimized. Disease process, prognosis, and therapeutic regimen understood. […] The focus of discharge instructions for patients with cholecystitis is education. […] Patients with cholecystitis must be educated regarding causes of their disease, complications if left untreated, and medical and surgical options.

• #1 Cholelithiasis and Cholecystitis Nursing Care Plan & Management

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/cholelithiasis-and-cholecystitis-nursing-management/

  Cholecystectomy is removal of the gallbladder after ligation of the cystic duct and artery. […] Cholecystomy is the surgical opening of the gallbladder for removal of stones, bile, or pus, after which a drainage tube is placed. […] Provide nursing interventions during an acute gallbladder attack. […] Administer IV fluids, monitor intake and output. […] Administer antibiotics if prescribed. […] Assess nutritional status. Encourage a high-protein, high-carbohydrate, low-fat diet. […] Maintain accurate record of IO, noting output less than intake, increased urine specific gravity. […] Monitor for signs and symptoms of increased or continued nausea or vomiting, abdominal cramps, weakness, twitching, seizures, irregular heart rate, paresthesia, hypoactive or absent bowel sounds, depressed respirations.

• #1 Nursing Care for Cholelithiasis – Made For Medical

  https://www.madeformedical.com/nursing-care-for-cholelithiasis-comprehensive-guide-for-effective-management/

  Implement pain relief strategies such as administering prescribed analgesics, providing comfort measures (e.g., heat therapy), and educating the patient on relaxation techniques. […] Emphasize the importance of maintaining strict aseptic techniques, encouraging hand hygiene, and monitoring signs of infection. […] Collaborate with a dietitian to develop a well-balanced diet plan considering the patients dietary restrictions. […] Offer emotional support and reassurance to alleviate anxiety and concerns related to the disease process and surgical interventions. […] Complications can arise in patients with cholelithiasis, such as acute cholecystitis or choledocholithiasis. […] As a nurse, be vigilant in monitoring for signs of complications and take prompt action. […] Monitor vital signs, and assess for worsening abdominal pain, fever, jaundice, or signs of sepsis.

• #1 4 Cholecystitis and Cholelithiasis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cholecystitis-cholelithiasis-nursing-care-plans/

  Patients with cholecystitis and cholelithiasis may experience acute pain due to obstruction of the gallbladder or bile ducts by gallstones, inflammation and irritation of the gallbladder wall, and tissue ischemia resulting from impaired blood flow to the affected area. […] The client will report relief or control of pain. […] Patients with cholecystitis and cholelithiasis are at risk for imbalanced nutrition, with less than the body’s requirements, due to dietary restrictions to avoid exacerbating symptoms, loss of nutrients from impaired digestion and absorption, impaired fat digestion and malabsorption, and pain and dyspepsia leading to decreased intake. […] The client will report relief from nausea/vomiting. […] Patients with cholecystitis and cholelithiasis may have deficient knowledge about the condition due to a lack of information or misinformation about the disease, misinterpretation of available information, and unfamiliarity with the medical terminology and concepts associated with the condition. […] The client will verbalize understanding of the disease process, prognosis, and potential complications.

• #1 Gallstones – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gallstones/diagnosis-treatment/drc-20354220

  Most people with gallstones that don’t cause symptoms will never need treatment. Your doctor will determine if treatment for gallstones is indicated based on your symptoms and the results of diagnostic testing. […] Your doctor may recommend that you be alert for symptoms of gallstone complications, such as intensifying pain in your upper right abdomen. If gallstone signs and symptoms occur in the future, you can have treatment. […] Treatment options for gallstones include: […] Surgery to remove the gallbladder (cholecystectomy). Your doctor may recommend surgery to remove your gallbladder, since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder. […] You don’t need your gallbladder to live, and gallbladder removal doesn’t affect your ability to digest food, but it can cause diarrhea, which is usually temporary.

• #1 Gallstones fact sheet | Emergency Care Institute

  https://aci.health.nsw.gov.au/networks/eci/clinical/ed-factsheets/gallstones

  If you are trialling non-operative therapy or are on the waiting list for surgery, there are steps you can take to reduce the chance of having further painful episodes or suffering from other complications of gallstones. These include: eating a healthy, balanced diet that includes lots of fruit and vegetables, gradual weight loss aiming for a healthy weight (avoid crash diets), drinking plenty of fluids to keep hydrated, limiting the amount of caffeine and alcohol you drink, keeping a diary of food and symptoms to help you identify trigger foods, avoiding fatty foods and excess oils when cooking as these make the gallbladder squeeze and can bring on a painful episode. […] You should see your doctor if you have pain that: is not controlled using simple, pain-relieving medications, like paracetamol or ibuprofen, does not go away after a few hours, is associated with a fever, stops you eating and drinking normally.

• #1 Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0815/p637.html

  Many patients with gallstones can be managed expectantly. […] Generally, only persons with symptoms related to the presence of gallstones (e.g., steady, nonparoxysmal pain lasting four to six hours located in the upper abdomen) or complications (such as acute cholecystitis or gallstone pancreatitis) warrant surgical intervention. […] Biliary pain is alleviated by cholecystectomy in the majority of cases. […] Laparoscopic cholecystectomy is considered the most cost-effective management strategy in the treatment of symptomatic gallstones. […] Patients with longer-lasting biliary pain, in combination with abdominal tenderness, fever, and/or leukocytosis, require an ultrasound evaluation to help establish a diagnosis of acute cholecystitis. […] Once a patient is diagnosed, having cholecystectomy early in the course of the disease can significantly reduce the hospital stay.

• #1

  https://www.nhs.uk/conditions/gallstones/treatment/

  Your treatment plan for gallstones depends on how the symptoms are affecting your daily life. […] If you have episodes of abdominal pain (biliary colic), treatment depends on how the pain affects your daily activities. […] If your symptoms are more severe and frequent, surgery to remove the gallbladder is usually recommended. […] The gallbladder isn’t an essential organ and you can lead a normal life without one. […] If surgery is recommended, you’ll usually have keyhole surgery to remove your gallbladder. […] A laparoscopic cholecystectomy may not be recommended if you: are in the third trimester (the last 3 months) of pregnancy, are extremely overweight, have an unusual gallbladder or bile duct structure that makes a keyhole procedure difficult and potentially dangerous. […] In these circumstances, an open cholecystectomy may be recommended.

• #1

  https://www.nhs.uk/conditions/gallstones/treatment/

  Open surgery is just as effective as laparoscopic surgery, but it does have a longer recovery time and causes more visible scarring. […] Endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure that can be used to remove gallstones from the bile duct. […] If your gallstones are small and don’t contain calcium, it may be possible to take ursodeoxycholic acid tablets to dissolve them. […] Ursodeoxycholic acid isn’t usually recommended for pregnant or breastfeeding women. […] A healthy diet won’t cure gallstones or completely eliminate your symptoms, but it can improve your general health and help control pain caused by gallstones.

• #1 Cholecystitis and Cholelithiasis | Diseases and Disorders

  https://nursing.unboundmedicine.com/nursingcentral/view/Diseases-and-Disorders/73556/all/Cholecystitis_and_Cholelithiasis

  A low-grade fever is often present, especially if the disease is chronic and the walls of the gallbladder have become infected. […] Right upper quadrant pain is intense in acute attacks and requires no physical examination. […] It is often followed by residual aching or soreness for up to 24 hours. […] A positive Murphy sign, which is positive palpation of a distended gallbladder during inhalation, may confirm a diagnosis. […] Patients not undergoing surgery or a procedure need clear explanations. […] Explain the disease process, the possible complications, and all medications. […] Teach the patient to avoid high-fat foods; dairy products; and, if the patient is bothered by flatulence, gas-forming foods. […] After a laparoscopic cholecystectomy, provide discharge instructions to a family member or another responsible adult as well as to the patient because the patient goes home within 24 hours after surgery.

• #1 Gallbladder – gallstones and surgery | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/gallbladder-gallstones-and-surgery

  After a gallbladder operation, you can expect to: feel mild pain in your shoulder from the carbon dioxide gas, receive pain-relieving medications, be encouraged to cough regularly to clear your lungs from the general anaesthetic, be encouraged to walk around as soon as you feel able, stay overnight in hospital, if you had a laparoscopic cholecystectomy, stay up to 8 days in hospital, if you had open surgery. […] Possible complications of cholecystectomy include: internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct, leakage of bile into the abdominal cavity, injury to blood vessels. […] Be guided by your doctor, but general self-care suggestions include: Rest as much as you can for around 3 to 5 days, Avoid heavy lifting and physical exertion, Expect your digestive system to take a few days to settle down. Common short-term problems include bloating, abdominal pains and changes to toilet habits.

• #1 Health tips after gallbladder removal surgery (cholecystectomy) to treat gallstones | Bangkok Hospital Headquarter

  https://www.bangkokhospital.com/en/content/gallbladder-surgery-aftercare

  Surgical removal of the gallbladder is considered an extremely effective form of treatment for gallstones. In addition to an appropriate surgical procedure conducted by expert surgeon, postoperative care plays an essential role in a fast recovery and quick return to daily life while preserving patients quality of life in the long run. […] After gallbladder removal surgery, it is highly recommended to follow these advices: […] To minimize the risk of pneumonia that might develop after surgery, the patient is advised to breathe deeply 5-10 times in each hour. […] To promote early mobility, the patient should refrain from lying in bed. Without provoking pain or discomfort, the patient can sit up straight and slowly walk around the bed. Daily activities must be resumed as soon as possible to improve blood circulation and prevent blood clot formation.

• #1 Gallstones (Cholelithiasis) Treatment & Management: Approach Considerations, Treatment of Asymptomatic Gallstones, Treatment of Patients with Symptomatic Gallstones

  https://emedicine.medscape.com/article/175667-treatment

  Following cholecystectomy, about 5%-10% of patients develop chronic diarrhea. […] Postcholecystectomy diarrhea is usually mild and can be managed with occasional use of over-the-counter antidiarrheal agents, such as loperamide. […] Many patients with postcholecystectomy syndrome have long-term functional pain that was originally misdiagnosed as being of biliary origin. […] Some individuals with postcholecystectomy syndrome have an underlying motility disorder of the sphincter of Oddi, termed biliary dyskinesia, in which the sphincter fails to relax normally following ingestion of a meal.

• #1 Dietary advice for patients with gallstones | CUH

  https://www.cuh.nhs.uk/patient-information/dietary-advice-for-patients-with-gallstones/

  If you find any particular foods trigger your symptoms, you could trial avoiding them to see if this helps. […] Try to eat regular meals, as fasting reduces gall bladder emptying which increases the risk of stones forming. […] Some people find that following a low fat diet can prevent episodes of pain from gallstones, or make them less frequent. However, this is not necessarily the case for everyone. […] If you are overweight, gradual weight loss can reduce the risk of developing gallstones. However, rapid weight loss (greater than 2 lbs or 1kg per week) may increase the chance of gallstone formation. […] A low fat diet may be beneficial if you suffer with steatorrhoea (pale, yellow, orange or oily stools which may float or be foul smelling). […] Your diet should not be completely fat free, a small amount of fat is needed by the body. You should try to choose low fat foods, but still eat a varied and healthy diet.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7632

  Gallstones are stones made of cholesterol and other substances that form in the gallbladder. […] Gallstones that block the gallbladder from emptying or get stuck in the bile duct can cause pain and infection. […] The doctor may have given you medicine for pain. You may need follow-up appointments for more testing and treatment. If you continue to have problems, you may need surgery to remove your gallbladder. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. […] Avoid foods that cause symptoms, especially fatty foods. These can make the gallbladder tighten and cause pain. […] Call your doctor or nurse advice line now or seek immediate medical care if: You are vomiting. You have new or worse belly pain. You have a fever. You cannot pass stools or gas. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

• #1 Dietary advice for patients with gallstones | CUH

  https://www.cuh.nhs.uk/patient-information/dietary-advice-for-patients-with-gallstones/

  If you have a cholecystectomy (removal of the gall bladder) you should be able to tolerate all foods and can return to a normal diet. […] Eating a healthy balanced diet, as outlined below, is beneficial for your general health. However, if you have lost a lot of weight or are underweight, following a low fat diet may make this worse. Please ask to speak to a Dietitian if this is the case. […] Some people find that following a low fat diet can prevent episodes of pain from gallstones, or make them less frequent. This leaflet outlines information which should allow you to follow a healthy, balanced and nutritionally adequate diet. Eating this way is also beneficial for your overall health. […] There is a risk you may lose weight. If you are underweight or concerned about weight loss please contact the dietitians on the number below. […] If you choose to eat high fat foods you may experience symptoms related to your gallstones such as pain.

• #1 Gallstones – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214

  Gallstones can block the tubes (ducts) through which bile flows from your gallbladder or liver to your small intestine. Severe pain, jaundice and bile duct infection can result. […] If your gallbladder doesn’t empty completely or often enough, bile may become very concentrated, contributing to the formation of gallstones. […] You can reduce your risk of gallstones if you: Don’t skip meals. […] If you need to lose weight, go slow. Rapid weight loss can increase the risk of gallstones. Aim to lose 1 or 2 pounds (about 0.5 to 1 kilogram) a week. […] Obesity and being overweight increase the risk of gallstones. Work to achieve a healthy weight by reducing the number of calories you eat and increasing the amount of physical activity you get.

• #1

  https://www.advocatehealth.com/health-services/digestive-health-center/conditions-we-treat/gallstones

  Your gallbladder is like that behind-the-scenes worker that quietly does its job without clamoring for attention. While its handy, your gallbladder isnt necessary for you to live. Many people have theirs removed and go about their lives just fine. […] At Advocate Health Care, our expert team of surgeons and clinicians have access to the latest technology and treatment options to provide the best possible care for gallstones. […] If you notice any of these potential gallstone symptoms persistently, it’s essential to see your doctor, as they could indicate complications or other related issues. […] Remember, while these diagnostic methods can detect gallstones, a doctor will also consider a patient’s gallstone symptoms and medical history to determine the best course of care for gallstones.

• #2 Gallstones (Cholelithiasis) | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22041

  Gallstones are among the most common causes of gastrointestinal dysfunction in the United States and worldwide. Gallstones can cause both chronic pain and episodic discomfort. They also cause acute disorders affecting the pancreatic, biliary, hepatic, and gastrointestinal tract. In the United States, over 6.3 million men and 14.2 million women between the ages of 20 and 74 have gallstones. Although most individuals with gallstones are asymptomatic, about 10% may develop symptoms within 5 years and 20% within 20 years of diagnosis. The prevalence of gallstones increases with age. Over 25% of women older than 60 have gallstones. […] Ultrasound is the preferred diagnostic modality for detecting gallstones, but gallstones may be visualized on computed tomography (CT), magnetic resonance imaging (MRI), and, depending on calcium content, even on x-rays. Treatment for gallstones depends on the clinical acuity and symptoms. The standard of care for patients experiencing recurrent biliary colic or acute cholecystitis is laparoscopic cholecystectomy. One million cholecystectomies are performed annually in the United States, at least half of which are secondary to biliary colic and chronic cholecystitis.

• #2 Gallstones – AGA GI Patient Center

  https://patient.gastro.org/gallstones/

  Gallstones are parts of the bile stored in the gallbladder, such as cholesterol and bilirubin, hardened into solid matter. Symptoms can be pain in the upper abdomen, vomiting and sweating. […] Gallstones are pieces of hard, solid matter that form over time in the gallbladder of some people. The gallbladder sits under the liver and stores bile (a key digestive “juice”). Gallstones form when the parts of bile — such as cholesterol and bilirubin — form crystals, much as sugar may collect in the bottom of a syrup jar. […] The most typical symptoms of gallstones (gallstone disease) is intermittent pain in the upper abdomen, usually on the right side or centrally. The pain may be severe. The pain may last for as little as 15 minutes or as long as several hours. The pain may also be felt between the shoulder blades or in the right shoulder.

• #2

  https://link.springer.com/article/10.1007/s11739-023-03355-z

  About 20% of adults worldwide have gallstones which are solid conglomerates in the biliary tree made of cholesterol monohydrate crystals, mucin, calcium bilirubinate, and protein aggregates. […] About 20% of gallstone patients will definitively develop gallstone disease, a condition which consists of gallstone-related symptoms and/or complications requiring medical therapy, endoscopic procedures, and/or cholecystectomy. […] Irrespective of composition, about 20% of gallstone patients will require appropriate medical, surgical, or endoscopic therapy due to gallstone-related symptoms or complications. […] The most characteristic uncomplicated symptom of gallstone disease is the biliary colic, defined as episodic attacks of severe pain in the right upper abdominal quadrant or epigastrium for at least 15-30 min with radiation to the right back or shoulder and a positive reaction to analgesics.

• #2 Nursing Care for Cholelithiasis – Made For Medical

  https://www.madeformedical.com/nursing-care-for-cholelithiasis-comprehensive-guide-for-effective-management/

  Review and interpret diagnostic test results, including ultrasound, computed tomography (CT) scan, or blood tests (e.g., liver function tests) to confirm the presence and severity of cholelithiasis. […] Formulate nursing diagnoses based on the assessment findings that will guide your care plan. […] Some common nursing diagnoses for cholelithiasis may include: Acute Pain related to gallstone obstruction and inflammation. […] Risk for Infection related to biliary stasis and potential complications. […] Imbalanced Nutrition: Less Than Body Requirements related to dietary restrictions and inadequate intake. […] Anxiety related to surgical intervention or uncertainty about the disease process. […] Develop a comprehensive nursing care plan to address the identified nursing diagnoses.

• #2 Cholelithiasis Nursing Interventions & Care Plan

  https://www.picmonic.com/pathways/nursing/courses/standard/medical-surgical-nursing-pathophysiology-296/biliary-disorders-1423/cholecystitis-interventions_2200

  Supportive treatment includes maintaining electrolyte and fluid status and providing a low fat diet. […] Maintaining the patient’s fluid and electrolyte balance is critical while providing supportive treatment to the patient with cholecystitis. […] Antibiotics are administered to treat bacterial infection that may be present in cholecystitis. […] To prevent flare-ups of biliary colic, educate the patient about the importance of adhering to a diet with minimal saturated fats, such as butter, shortening, or lard. […] Inserting a nasogastric (NG) tube in the patient with cholecystitis experiencing severe vomiting will help decompress the stomach and minimize gallbladder stimulation. […] Pain management using analgesics is critical during an acute episode of cholecystitis. […] If the patient’s cholecystitis is caused by the formation of gallstones, lithotripsy may be indicated. […] A cholecystectomy is the surgical removal of the gallbladder. […] After gallbladder surgery, a T tube may be inserted into the common bile duct. The T tube allows excess bile to drain as the small intestines adjust to receiving continuous bile flow.

• #2 Cholelithiasis and Cholecystitis Nursing Care Plan & Management

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/cholelithiasis-and-cholecystitis-nursing-management/

  Cholecystectomy is removal of the gallbladder after ligation of the cystic duct and artery. […] Cholecystomy is the surgical opening of the gallbladder for removal of stones, bile, or pus, after which a drainage tube is placed. […] Provide nursing interventions during an acute gallbladder attack. […] Administer IV fluids, monitor intake and output. […] Administer antibiotics if prescribed. […] Assess nutritional status. Encourage a high-protein, high-carbohydrate, low-fat diet. […] Maintain accurate record of IO, noting output less than intake, increased urine specific gravity. […] Monitor for signs and symptoms of increased or continued nausea or vomiting, abdominal cramps, weakness, twitching, seizures, irregular heart rate, paresthesia, hypoactive or absent bowel sounds, depressed respirations.

• #2 Patient education: Gallstones (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gallstones-beyond-the-basics/print

  If you have silent gallstones, you should be aware of the initial symptoms of gallstone disease because you may need treatment if you develop symptoms. […] Biliary colic — Biliary colic, also known as gallstone pain or biliary pain, is the most common initial symptom of gallstones. It manifests as attacks of abdominal pain, often located in the right upper belly just under the lower ribs. […] Once you have a first attack of biliary colic, there is a good chance you will have more symptoms in the future. Such recurrent symptoms are usually more severe and occasionally associated with complications. […] Acute cholecystitis — This refers to inflammation of the gallbladder. It happens when there is a complete blockage of the gallbladder, caused by a gallstone. […] Treatment includes IV fluids, pain medicine, and usually antibiotics. Surgery to remove the gallbladder along with its contained stones is usually recommended during the hospitalization or shortly thereafter.

• #2 Gallstones (Cholelithiasis): Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/7313-gallstones

  If your gallstones never cause problems, you wont need treatment for them. But if gallstones cause a blockage in your biliary tract, your healthcare provider will want to remove them not just the blockage, but all of them. Once gallstones have caused a blockage, theyre highly likely to do so again. […] Healthcare providers dont prescribe medications for gallstones very often because they arent very effective. Medications like ursidol and chenodiol only work on smaller cholesterol stones that havent caused any complications yet. […] Theres no sure way to prevent gallstones from forming, but you can take certain steps to reduce your overall risk. […] If you develop sudden stabbing pain in your upper right abdomen or shoulder, especially after eating, you might be having a gallbladder attack. Seek medical attention right away. […] Gallstones are common, and most people will never be bothered by them. If they stay put, you may never know theyre there. But once they begin to move, they become dangerous.

• #2

  https://www.nhs.uk/conditions/gallstones/treatment/

  Your treatment plan for gallstones depends on how the symptoms are affecting your daily life. […] If you have episodes of abdominal pain (biliary colic), treatment depends on how the pain affects your daily activities. […] If your symptoms are more severe and frequent, surgery to remove the gallbladder is usually recommended. […] The gallbladder isn’t an essential organ and you can lead a normal life without one. […] If surgery is recommended, you’ll usually have keyhole surgery to remove your gallbladder. […] A laparoscopic cholecystectomy may not be recommended if you: are in the third trimester (the last 3 months) of pregnancy, are extremely overweight, have an unusual gallbladder or bile duct structure that makes a keyhole procedure difficult and potentially dangerous. […] In these circumstances, an open cholecystectomy may be recommended.

• #2 Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0815/p637.html

  Patients with biliary pain should have laparoscopic cholecystectomy on first open operative day. […] Patients with acute cholecystitis should have a laparoscopic cholecystectomy early in their management course. This reduces the hospital stay but does not reduce the complication rate compared with delayed surgery. […] Patients with gallstone pancreatitis should have a laparoscopic cholecystectomy during the same hospitalization. […] Cholecystectomy remains the primary procedure for the management of symptomatic gallstone disease. […] It is safe, has the lowest risk of recurrence, and provides 92 percent of patients with complete relief of their biliary pain. […] Indications for cholecystectomy are listed in Table 3. […] Between 5 and 26 percent of patients undergoing elective laparoscopic cholecystectomy will require conversion to an open procedure.

• #2 Gallstones (Cholelithiasis) Treatment & Management: Approach Considerations, Treatment of Asymptomatic Gallstones, Treatment of Patients with Symptomatic Gallstones

  https://emedicine.medscape.com/article/175667-treatment

  The traditional open approach to cholecystectomy employed a large, right subcostal incision. […] In contrast, laparoscopic cholecystectomy employs four very small incisions. […] Currently, laparoscopic cholecystectomy is commonly performed in an outpatient setting. […] In patients who are critically ill with gallbladder empyema and sepsis, cholecystectomy can be treacherous. […] In this circumstance, the surgeon may elect to perform cholecystostomy, a minimal procedure involving placement of a drainage tube in the gallbladder. […] If surgical removal of common bile duct stones is not immediately feasible, endoscopic retrograde sphincterotomy can be used. […] Ursodeoxycholic acid treatment can prevent gallstone formation. […] Recommending dietary changes of decreased fat intake is prudent; this may decrease the incidence of biliary colic attacks.

• #2 Gallstones (Cholelithiasis) Treatment & Management: Approach Considerations, Treatment of Asymptomatic Gallstones, Treatment of Patients with Symptomatic Gallstones

  https://emedicine.medscape.com/article/175667-treatment

  Medical treatments for gallstones, used alone or in combination, include the following: Oral bile salt therapy (ursodeoxycholic acid) (particularly for x-ray-negative cholesterol gallstones in patients with normal gallbladder function), Extracorporeal shockwave lithotripsy (particularly for noncalcified cholesterol gallstones in patients with normal gallbladder function). […] Medical management is more effective in patients with good gallbladder function who have small stones ( 1 cm) with a high cholesterol content. […] Surgical treatment of asymptomatic gallstones without medically complicating diseases is discouraged. […] The risk of complications arising from interventions is higher than the risk of symptomatic disease. […] However, cholecystectomy for asymptomatic gallstones may be indicated in the following patients: Patients with large gallstones, greater than 2 cm in diameter, Patients with nonfunctional or calcified (porcelain) gallbladder observed on imaging studies and who are at high risk of gallbladder carcinoma, Patients with spinal cord injuries or sensory neuropathies affecting the abdomen, Patients with sickle cell anemia in whom the distinction between painful crisis and cholecystitis may be difficult.

• #2 Gallbladder – gallstones and surgery | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/gallbladder-gallstones-and-surgery

  After a gallbladder operation, you can expect to: feel mild pain in your shoulder from the carbon dioxide gas, receive pain-relieving medications, be encouraged to cough regularly to clear your lungs from the general anaesthetic, be encouraged to walk around as soon as you feel able, stay overnight in hospital, if you had a laparoscopic cholecystectomy, stay up to 8 days in hospital, if you had open surgery. […] Possible complications of cholecystectomy include: internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct, leakage of bile into the abdominal cavity, injury to blood vessels. […] Be guided by your doctor, but general self-care suggestions include: Rest as much as you can for around 3 to 5 days, Avoid heavy lifting and physical exertion, Expect your digestive system to take a few days to settle down. Common short-term problems include bloating, abdominal pains and changes to toilet habits.

• #2 Cholecystitis and Cholelithiasis | Diseases and Disorders

  https://nursing.unboundmedicine.com/nursingcentral/view/Diseases-and-Disorders/73556/all/Cholecystitis_and_Cholelithiasis

  A low-grade fever is often present, especially if the disease is chronic and the walls of the gallbladder have become infected. […] Right upper quadrant pain is intense in acute attacks and requires no physical examination. […] It is often followed by residual aching or soreness for up to 24 hours. […] A positive Murphy sign, which is positive palpation of a distended gallbladder during inhalation, may confirm a diagnosis. […] Patients not undergoing surgery or a procedure need clear explanations. […] Explain the disease process, the possible complications, and all medications. […] Teach the patient to avoid high-fat foods; dairy products; and, if the patient is bothered by flatulence, gas-forming foods. […] After a laparoscopic cholecystectomy, provide discharge instructions to a family member or another responsible adult as well as to the patient because the patient goes home within 24 hours after surgery.

• #2 Health tips after gallbladder removal surgery (cholecystectomy) to treat gallstones | Bangkok Hospital Headquarter

  https://www.bangkokhospital.com/en/content/gallbladder-surgery-aftercare

  It is important to regularly observe any abnormal signs and symptoms that might potentially indicate postoperative complications, e.g. pain, swelling and redness. If any of these abnormalities arises, keep the surgeon informed immediately. […] For patients who underwent laparoscopic cholecystectomy, it involves insufflation of gas (usually carbon dioxide) into the peritoneal cavity. Therefore, the patients often experience pain or discomfort caused by excess gas, e.g. shoulder pain which normally subsides within 1-2 days. Continuous mobilization and walking can help to mitigate pain. […] Generally, a surgery to remove gallbladder does not bring about any postoperative complications. However, 1-2 follow-up appointments will be scheduled by the surgeon within 2-3 weeks after surgery in order to monitor treatment outcomes and watch out for possible complications.

• #2 Cholelithiasis (Gallstones): Symptoms, Causes, and Treatments

  https://resources.healthgrades.com/right-care/gallbladder-removal-surgery/cholelithiasis-gallstones

  The gallbladder is not an essential organ. Most people who have a cholecystectomy can live a normal life afterward. Some people have softer stools and frequent bowel movements in the first few weeks after surgery. This usually resolves within 3 months. Eating a low fat diet can help while your body learns to adjust.

• #2 Gallstone Disease | Transplant Division | SUNY Downstate

  https://www.downstate.edu/patient-care/find-treatment/treatment-centers/transplant-division/liver-pancreas-biliary-tree/gallstone-disease.html

  Most people that have gallstones do not experience any symptoms, however sometimes a gallstone can obstruct the gallbladder and prevent it from draining the bile into the intestine. This causes an infection in the gallbladder called Cholecystitis. […] Whether you have Biliary Colic, Acute Cholecystitis, Bile duct stones, or Ascending Cholangitis it is recommended that your gallbladder is removed if you can safely undergo surgery. […] The surgery to remove you gallbladder is called Cholecystectomy and it is usually done laparoscopically, which means through small incisions rather than one big incision. […] Sometimes, a stone may block your bile duct. This is called Choledocholithiasis. […] Nutrition intervention summarized: […] Symptomatic gallstones, acute attacks, and cholecystitis require a low-fat diet.

• #2 Dietary advice for patients with gallstones | CUH

  https://www.cuh.nhs.uk/patient-information/dietary-advice-for-patients-with-gallstones/

  If you find any particular foods trigger your symptoms, you could trial avoiding them to see if this helps. […] Try to eat regular meals, as fasting reduces gall bladder emptying which increases the risk of stones forming. […] Some people find that following a low fat diet can prevent episodes of pain from gallstones, or make them less frequent. However, this is not necessarily the case for everyone. […] If you are overweight, gradual weight loss can reduce the risk of developing gallstones. However, rapid weight loss (greater than 2 lbs or 1kg per week) may increase the chance of gallstone formation. […] A low fat diet may be beneficial if you suffer with steatorrhoea (pale, yellow, orange or oily stools which may float or be foul smelling). […] Your diet should not be completely fat free, a small amount of fat is needed by the body. You should try to choose low fat foods, but still eat a varied and healthy diet.

• #2 Gallstone Disease | Transplant Division | SUNY Downstate

  https://www.downstate.edu/patient-care/find-treatment/treatment-centers/transplant-division/liver-pancreas-biliary-tree/gallstone-disease.html

  It is recommended for patients to consume small, frequent meals throughout the day with snacks. Fat should be limited to less than 30% of your daily calories, make sure to choose low-fat food items. […] It is strongly recommended to consume a well-balanced diet (i.e. fruits, vegetables, whole grains, healthy fats), especially foods high in calcium and Vitamin D to prevent osteoporosis.

• #2 Patient education: Gallstones (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gallstones-beyond-the-basics/print

  Gallstone recurrence — The main disadvantage of the non-surgical treatments is that gallstones can come back since the gallbladder is still in place. […] However, symptoms do not always come back, and retreatment is not always needed. After cholecystectomy, gallstones may recur in the bile duct in a small percentage of patients. […] Gallstone prevention — To try to prevent gallstones from coming back, it is recommended that you try to stay at a healthy body weight by eating an appropriate number of calories and exercising for at least 30 minutes five days per week.

• #2 Gallstones – discharge Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/discharge-instructions/gallstones-discharge

  You may continue to have pain and other symptoms if your gallstones return or were not removed. If you had a cholecystectomy, you will be given instructions to follow up after surgery. […] You may be on a liquid diet for some time to give your gallbladder a rest. When you are eating regular food again, avoid overeating. If you are overweight try to lose weight. […] Take any medicines you have been given to fight infection the way you were told to. You may be able to take medicines that dissolve gallstones, but they may take 6 months to 2 years to work, and the gallstones return after stopping the medicine. […] Contact your provider if you have: Steady, severe pain in your upper belly […] Pain in your back, right shoulder, or between your shoulder blades that does not go away and is getting worse […] Nausea and vomiting […] Fever or chills […] Yellow color to your skin and the whites of your eyes (jaundice) […] Grey or chalky white bowel movements.

• #2 4 Cholecystitis and Cholelithiasis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cholecystitis-cholelithiasis-nursing-care-plans/

  Cholecystitis is the inflammation of the gallbladder, usually associated with gallstones impacted in the cystic duct. […] Nursing care planning and management for patients with cholecystitis include relieving pain and promoting rest, maintaining fluid and electrolyte balance, preventing complications, and provision of information about the disease process, prognosis, and treatment. […] Patients with cholecystitis and cholelithiasis are at risk for deficient fluid volume due to excessive losses resulting from vomiting or diarrhea, limited intake due to nausea and anorexia, and altered clotting processes due to liver dysfunction. […] The client will demonstrate adequate fluid balance evidenced by stable vital signs, moist mucous membranes, good skin turgor, capillary refill, individually appropriate urinary output, and absence of vomiting.

• #2 Gallstones | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/g/gallstones.html

  If stones in your gallbladder cause a blockage of bile acid and subsequent infection, your gallbladder will have to be removed. But if you are too sick to have surgery or there are other complications, a drainage tube may be inserted into your gallbladder through the skin of your abdomen. This will temporarily bypass the blockage and drain any infection. […] Most people respond very well once their stones are dissolved or taken out. […] If your gallstones cause no symptoms, treatment is often not needed. […] If symptoms don’t go away, you will need treatment to remove the gallstones. […] If stones are in your gallbladder, the gallbladder must generally be removed. This is a common surgery.

• #3 Cholelithiasis and Cholecystitis Nursing Care Plan & Management

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/cholelithiasis-and-cholecystitis-nursing-management/

  Maintain NPO status, insert and/or maintain NG suction as indicated. […] Administer medications as indicated: Anticholinergics: atropine, propantheline (Pro-Banth-ne); […] Chenodeoxycholic acid (Chenix), ursodeoxycholic acid (Urso, Actigall); […] Discuss weight reduction programs if indicated. […] Instruct patient to avoid food/fluids high in fats (pork, gravies, nuts, fried foods, butter, whole milk, ice cream), gas producers (cabbage, beans, onions, carbonated beverages), or gastric irritants (spicy foods, caffeine, citrus). […] Review signs and symptoms requiring medical intervention: recurrent fever; persistent nausea and vomiting, or pain; jaundice of skin or eyes, itching; dark urine; clay-colored stools; blood in urine, stools, vomitus; or bleeding from mucous membranes.

• #3 Treatment for Gallstones – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/treatment

  Surgery to remove the gallbladder, called cholecystectomy, is one of the most common operations performed on adults in the United States. […] A health care professional will usually give you general anesthesia for surgery. […] Surgeons perform two types of cholecystectomy: […] Almost all surgeons perform cholecystectomies with laparoscopy. […] A surgeon performs an open cholecystectomy when your gallbladder is severely inflamed, infected, or scarred from other operations. […] All surgeries come with a possible risk of complications; however, gallbladder surgery complications are very rare. […] Doctors use nonsurgical treatments for gallstones only in special situations, like if you have cholesterol stones and you have a serious medical condition that prevents surgery. […] A doctor may use the following types of nonsurgical treatments to remove or break up cholesterol gallstones: […] You can help prevent gallstones by adjusting your eating plan to include more foods high in fiber and healthy fats, fewer refined carbohydrates, and less sugar.

• #3 Cholecystitis and Cholelithiasis | Diseases and Disorders

  https://nursing.unboundmedicine.com/nursingcentral/view/Diseases-and-Disorders/73556/all/Cholecystitis_and_Cholelithiasis

  Explain the possibility of abdominal and shoulder pain caused by the instillation of carbon dioxide so that if the pain occurs, the patient will not experience unnecessary anxiety about a heart attack. […] The continued use of opiate-type analgesics for 7 to 10 days may necessitate the use of laxatives or suppositories, which are generally prescribed by the physician before discharge.

• #3 Health tips after gallbladder removal surgery (cholecystectomy) to treat gallstones | Bangkok Hospital Headquarter

  https://www.bangkokhospital.com/en/content/gallbladder-surgery-aftercare

  To maintain a good health after gallbladder surgery, it is vital to strictly follow these eating tips: […] Limit fatty and greasy food to minimize bloating and diarrhea: As the body still requires essential fatty acids derived from food, the patient can gradually start eating high-fat food in limited amount. […] ERAS program is considered a multimodal perioperative care pathway designed to achieve early recovery after surgical procedures. The key elements of ERAS are comprised of patient and family education, general health optimization prior to operation, pre-rehabilitation, minimal fasting, multimodal analgesia with appropriate use of opioids, early mobilization, early removal of urinary drainage, quick initiation of oral feeding and fast recovery.

• #3 Gallstone Disease | Transplant Division | SUNY Downstate

  https://www.downstate.edu/patient-care/find-treatment/treatment-centers/transplant-division/liver-pancreas-biliary-tree/gallstone-disease.html

  Most people that have gallstones do not experience any symptoms, however sometimes a gallstone can obstruct the gallbladder and prevent it from draining the bile into the intestine. This causes an infection in the gallbladder called Cholecystitis. […] Whether you have Biliary Colic, Acute Cholecystitis, Bile duct stones, or Ascending Cholangitis it is recommended that your gallbladder is removed if you can safely undergo surgery. […] The surgery to remove you gallbladder is called Cholecystectomy and it is usually done laparoscopically, which means through small incisions rather than one big incision. […] Sometimes, a stone may block your bile duct. This is called Choledocholithiasis. […] Nutrition intervention summarized: […] Symptomatic gallstones, acute attacks, and cholecystitis require a low-fat diet.

• #3 Gallstones – discharge: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/patientinstructions/000196.htm

  You may continue to have pain and other symptoms if your gallstones return or were not removed. If you had a cholecystectomy, you will be given instructions to follow up after surgery. […] You may be on a liquid diet for some time to give your gallbladder a rest. When you are eating regular food again, avoid overeating. If you are overweight try to lose weight. […] Take any medicines you have been given to fight infection the way you were told to. You may be able to take medicines that dissolve gallstones, but they may take 6 months to 2 years to work, and the gallstones return after stopping the medicine. So, this medicine is not used a lot. That’s why if you have symptomatic gallstones, your gallbladder is removed. […] Contact your provider if you have: Steady, severe pain in your upper belly, Pain in your back, right shoulder, or between your shoulder blades that does not go away and is getting worse, Nausea and vomiting, Fever or chills, Yellow color to your skin and the whites of your eyes (jaundice), Grey or chalky white bowel movements.

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