Recovery after removal of the gallbladder

The removal of the gallbladder is a frequent operation. It is necessary for diseases of the biliary system, cholelithiasis, polyps, cholecystitis, neoplasms. Surgical intervention can be carried out by open access, laparoscopically and with a mini-access. Recovery after removal of the gallbladder directly depends on the method of cholecystectomy.

The main rehabilitation areas are - diet, medication, treatment of the wound, avoidance of excessive physical exertion. After the intervention, the body takes time to learn to cope without an organ that has stored bile.

During the operation, a cut of the abdominal wall is made, therefore, in the postoperative period, care should be taken carefully as to how the healing proceeds. If the recommendations regarding exercise and nutrition are not complied with, due to the proliferation of fibrous tissue, spikes may form.

Methods of organ removal

Cholecystectomy is performed using laparotomy, laparoscopy or a mini-access. When laparotomy on the abdominal wall, an incision is made( approximately 15 cm) through which the gallbladder( HP) is removed. The method is used if an emergency operation is performed, there are contraindications to laparoscopy, acute inflammation with peritonitis or complex duct damage is diagnosed.

Because the operation is cavitary, it takes a long period to recover. With normal healing, the sutures are removed for 7-10 days. Inpatient the patient is from 2 weeks. After 14-20 days the patient already returns to the usual way of life, but continues to adhere to dietary nutrition, avoids weight lifting( for half a year) and bathing in water reservoirs and pools.

Laparoscopic cholecystectomy is considered a minimally invasive intervention. During the operation, in the abdominal wall 4 cuts of 2 centimeters are made, through which the equipment for manipulation is introduced. With laparoscopy, the patient recovered quickly and can leave the hospital after 2-3 days and quickly return to normal life.

With a mini-access, the surgeon cuts the abdominal wall 3-7 cm. This incision is less traumatic than with open access, but it provides the necessary overview to determine the state of the organs. This method is used for adhesions, inflammatory tissue infiltration, when carbon dioxide can not be introduced.

The larger the incision of the anterior abdominal wall, the longer the recovery period

How long does

last? Depending on the cholecystectomy method chosen by the surgeon, the length of rehabilitation will depend. After open surgery, the work capacity is restored within 1-2 months, and after laparoscopy a person is on the sick-list for no more than 20 days. The rehabilitation period can be divided into several stages:

• early ( in the hospital).Lasts for two days after the operation. During this period, the doctors monitor the patient's condition: how he feels after anesthesia, if the postoperative complications. If necessary, symptomatic therapy is performed;
• late stage .The patient is still in the hospital. Doctors watch how the body works without a gallbladder, whether the work of the intestine is not broken, how the wound heals. This period is 3-6 days with laparoscopy and up to 14 days after laparotomy;
• out-patient rehabilitation .The organism fully adapts to new conditions, digestion and well-being are restored. It lasts 1-3 months depending on the type of intervention.

Within 4-6 hours after treatment it is not allowed to eat and drink, get out of bed. After six hours you can get up, but only carefully, as after anesthesia there may be dizziness. With pain in the incision area, all patients collide, but the intensity and duration of the pain syndrome is different.

So, after laparotomy, the patient is given narcotic painkillers( Promedol), and then non-narcotic analgesics( Tramadol, Paracetamol), and after laparoscopy, soreness is described as tolerable and the person does not need painkillers. The next day after removal of the body is allowed to get up, a little bit like.

At discharge from the hospital, the doctor will tell you how to speed up recovery after cholecystectomy. They concern recommendations of diet, exercise, medication, grooming. Only following the prescriptions of the doctor can quickly recover and avoid postoperative complications.

Diet during rehabilitation

The gallbladder accumulated bile, synthesized by the liver, and it was ejected into the small intestine. After removal of the body, bile enters the intestine gradually and therefore more time is required to digest food. To speed up digestion, it is important to comply with the prescriptions for dietary nutrition.

With the use of "right" foods, food will be digested faster, which means there will be no reflux, increased gas production, fermentation and putrefaction in the intestine. In the early days you can eat only porridge, non-welded soups, sour-milk products, lean boiled meat, puree from vegetables, bananas. After discharge from the hospital, the patient should also follow a diet.

Recommended table No5

It is forbidden to eat fried and fatty dishes, smoked products, spices, canned food, marinades, sweets, butter, eggs, you can not drink coffee, alcohol. Digestion will recover faster, if not only adhere to a diet, but also observe the schedule of food intake. For a month after discharge from the hospital, you need to arrange 5-6 meals a day.

Food should be eaten in small portions every 3 hours. It is advisable to eat at the same time, so that bile is produced by a certain time. Before eating( for 10-15 minutes) it is recommended to drink a glass of water to make the gland work.

Drug treatment

Since removal of the gallbladder is carried out as a last resort, it is likely that the inflamed organ has affected the functions of other organs. Often in the postoperative period, the clinic is strengthened, since the body has not yet adapted to the new conditions. Depending on the complications, the physician will be prescribed the necessary medicines.

So, with the manifestation of reflux, antireflux medications are prescribed, if there are erosions on the stomach mucosa, then drugs that reduce acidity of gastric juice and enveloping body walls are indicated. Treatment after removal of the gallbladder with medicines, as a rule, is not required. To normalize digestion, medicines with enzymes are usually prescribed( Mezim, Festal, Pancreatin).

Choleretic preparations may also be recommended. To improve the excretion of bile in consultation with a doctor, cholagogue can be used. Useful beet juice( first it needs to be diluted with water), a decoction of corn stigmas and tansy, and also from immortelle, roots of rhubarb and yarrow. To stimulate bile secretion, you can use the following method. Before breakfast, drink a glass of warm mineral water without gas( Essentuki 17), lie on your right side and attach a warm water bottle to your liver for 30-40 minutes.

Physical activity

During the wound healing period( within a month), it is necessary to limit physical activity, do not make sharp turns and do not lift more than 2-3 kilograms, do not perform exercises in which the muscles of the press are involved. After healing of the dissected tissues, one can begin to practice physical therapy.

The load on the muscles of the press should increase gradually, it is recommended to do the exercise "scissors", "bicycle".Useful long-term walking at a fast pace. Adequate physical exercise will help improve the intestinal motility, will increase the supply of tissues with oxygen. If you ignore the restriction and lift the gravity, then the seams can disperse or a hernia is formed.

At the end of six months after the operation, any restrictions related to physical exertion are removed

Wound care

At the site of tissue dissection, inflammation and swelling occur. In the absence of proper care of the seam, a suppuration or hypertrophic scar, a keloid, may occur. One of the important factors that affect wound healing is the number of bacterial flora in the wound( the wound heals longer due to the action of bacterial proteases).

Around the wound can be redness, condensation. Wound infection occurs in 1-2% of patients. If you have severe inflammation, you need to see a doctor, because if the wound is inflamed, surgical intervention may be required to sanitize and take an antibiotic.

You can take a shower two days after the operation. Water does not penetrate into the wound, but do not rub it with a washcloth or soap. After water procedures, the wound should be smeared with iodine or zelenka. Bathing in the bath is allowed only 5 days after the removal of stitches.

Complications after surgical intervention

Statistically, 12 individuals out of 100 after operations begin to form adhesions. After removal of the HP, spasms are formed between the small and large intestine. They appear, as the connective tissue grows, it is a scar on the internal organs.

With spikes, soreness in the scar area may appear, which is aggravated by physical exertion, dyspepsia, defecation, intestinal obstruction, necrosis of the intestine. If there is a suspicion of an adhesion process, then a diagnostic laparoscopy is performed for confirmation. Treatment involves cutting the abdominal wall.

It is necessary to shorten the duration of bed rest, the earlier the patient starts walking, the less the risk of adhesion. Doctors advise on the second day after the operation to slowly slowly get up, turn in bed, walk a little. Preventive measures in the postoperative period include bowel stimulation( enema, injections of prozerin), administration of anti-inflammatory drugs, compliance with the diet.

During the operation the patient is on the ventilator, therefore the respiratory function is disrupted. As a complication, pneumonia may develop. To avoid unpleasant consequences from the respiratory system, experts advise doing respiratory gymnastics. It is recommended to perform 6-8 times a day for 15 deep breaths and quickly exhale the air with your mouth.

To prevent spikes from forming, after cholecystectomy, the recommendations related to physical activity of

should be followed. Possible complications after cholecystectomy:

• intestinal obstruction;
• formation in the intestinal fistula;
• failure of drainage tubes into the abdominal cavity;
• suppuration of the joint.

If there are painful sensations in the area of ​​the scar, difficulty with bowel movement, increased gas formation, dyspeptic disorders, it is necessary to consult a doctor.

A person after removal of the HP within 2-3 weeks can return to the usual way of life. Follow the diet for a month.

After the menu expands, but still it is necessary to adhere to a healthy diet and limit the dishes, which require a lot of bile for fission( fried and fatty).Month after surgery, you can not strain your stomach( lift weights, swing the press).Otherwise, there are no significant limitations, and after removal of the gallbladder, one can return to the habitual way of life.