Lap Chole post op care

[NPJohnson]

Do they have a Jackson Pratt drain? What other considerations are there?

[Sarah, RNBScN]

CO2 is used to inflate the abdomen (pneumoperitoneum). Three trocar incisional areas are made. Instruments are placed through these openings to dissect away the gallbladder. Once it is successfully removed, the CO2 is shut off and most surgeons will allow for the abd. to deflate back to its original state. Sometimes a JP is used. Incisional areas are sutured and steri stips secured with little window dressings.

This is just a brief overview.

Are you having this surgery done?

[Sarah, RNBScN]

Our post op go home the same day with a community health nurse follow up for assessment and sedation medication. Most pts. do very well and require the sedation once. It is rare to keep them overnight.

[mags-rn]

Here - Generally speaking, no - no drains. Rarely they may come out with a T-tube, but again that is very rare. The only real consideration is to watch for bleeding from the clipped artery. A rare potential complication is a missed stone in the common bile duct. This can be corrected either with surgery or an ERCP to grab the stone. Of course, a patient might go into surgery expecting laparoscopic surgery, and come out with an open chole.

Diet is something to counsel the patient about. The body needs time to adjust to a reduced amount of bile released when fatty foods are eaten. Food tolerances might be changed. Go slow when introducing fatty foods (of course, this is an opportunity to change one's diet for the better!).

Hope this helps.

[uhsmdc]

tell me more abouta chole tube.

[iluvivt, BSN, RN]

FYI...The diaphram often gets irritated from the Co2 gas and can be very bothersome to downright painful. I speak from experience. The Phrenic nerve can get irritated and cause hiccups and there can be some shoulder pain as well.

[JBizzleRN, ADN, RN]

Usually our Lap Chole patients go home the same day unless there we some complications. A lot of the gas does get trapped in the abdomen and people complain of pain even though they have a PCA. The PCA is not going to touch that gas pain. That is why it is important to start ambulation ASAP! That will help get the gas moving out of the abdominal area and make you feel a lot better :-)

I agree w/ the above. I have seen I think one JP drian used in an Lap. Chole...and that was due to excessive drainage. But otherwise they usually come out with three incisions usually dermabanded or with telfa and a tegaderm over them, just depends on what surgeon does it.