Laparoscopic Cholecystectomy

Transcription

1 Treatment Centre Laparoscopic Cholecystectomy What is a laparoscopic cholecystectomy? You need this operation because stones have collected in your gallbladder (the area where a small amount of bile is usually stored). These stones are now giving you symptoms and the gallbladder needs to be removed, together with the stones. Your body can function perfectly normally without a gallbladder. The operation can be performed using a laparoscopic technique (known as keyhole surgery). This means you will have several very small cuts in your abdomen. A telescopic camera and other fine instruments will be inserted through these cuts in order to remove the gallbladder. Alternative options for treatment Any suitable alternative treatment should have been discussed with you at your outpatient appointment. If this was not the case, please ask for further information. Preparation required before surgery On the day of your operation please have a bath or shower and wear loose fitting clothes. The consultant surgeon or one of his team will already have discussed the operation with you in detail in the surgical outpatient clinic. You will be required to have a pre-operative assessment with a nurse with regard to your suitability to be a day case. This means that you may go home on the same day as your operation. At the pre-operative assessment, you will be given pathology request forms for blood tests. Please arrange to have these blood tests taken 2 weeks prior to your operation date. You will then need to inform the pre-assessment nurse that you have had the blood tests taken so that the results can be reviewed prior to your operation. If you need this information in another format or language please telephone Further information about the Trust is available on the following websites: KGH - NHS Choices - Ref: PI 033 February 2017 Next review: November 2018

2 What will happen when you arrive on the unit? The surgeon will ask you to sign a consent form for your operation. The anaesthetist (a doctor who sends you off to sleep and helps with pain control) will ask you some questions about your general health. You will be given graduated compression stockings to wear on your legs prior to the operation, and following discharge. This is to help prevent a deep vein thrombosis (DVT), also referred to as a blood clot. Following surgery Following surgery you will be transferred to the recovery ward. Here, you will be looked after for at least six hours and you will be closely monitored. You will have a drip in your hand / arm whilst you are unable to drink. You will then be offered a drink about 2 hours after your operation and soon after that you will be offered something light to eat. Going home You must be taken home in a car or taxi and be accompanied by a responsible adult (18 years or over). It is also advisable that you have a responsible adult who will stay with you for 24 hours following surgery. It is anticipated that your length of stay will be the whole day. Please ensure that once you are ready, the person who is coming to collect you is prompt as you need to rest and your recovery will be more comfortable at home. Please give the Carer s Leaflet to the person collecting you and the person who will be staying with you. It is advisable to have someone with you at home for 2-3 days. It is important to remember that although you have been allowed home straight after surgery you will still need a few days to fully recover. What are the risks? There is a one in 20 chance that a laparoscopic operation will be converted to an open procedure. This is where the surgeon makes a bigger cut in your abdomen to remove your gallbladder. Damage to the bile duct happens once in 300 laparoscopic cholecystectomies. There is also a very small risk of bleeding and infection. If your wounds become red, hot to the touch, painful, swollen, or if you feel unwell, you must seek medical advice. Risks related to a general anaesthetic are summarised in the leaflet You and your anaesthetic

3 What are the benefits? The main benefit from this operation is to relieve your symptoms and for you to return to a normal diet. Post-surgery instructions Diet Try to eat a well-balanced nutritious diet. You may find that you prefer small light meals for the first few days. Pain control You may have some mild pain for up to a week after the operation. You may also have some neck and shoulder tip pain; this is due to the gas used (carbon dioxide) to enable a clear view inside your tummy, which can get trapped. It will disappear by itself after a couple of days. However, it is important to take your pain relief medication regularly for the first few days after your discharge. Wound care Usually the stitches are dissolvable (but may take up to 2 months to disappear completely). If non-dissolvable stitches are used you will need to make an appointment to see the practice nurse at your GP surgery for these to be removed in 6 8 days. You will have several small dressings on your wounds, which can be removed 48 hours after your operation. You may notice some bruising around the suture [stitches] area, do not worry this will disappear within a couple of weeks. You can have a bath or shower after 48 hours, but, for a week, you should avoid long soaks in the bath. Activity We encourage early movement after surgery to reduce the risk of thrombosis (blood clots) and chest infection. The day after your operation you may walk around the house, but it is not advisable to go out. You should avoid heavy lifting for 2 weeks after the operation. Statement of Fitness for Work [a Fit Note] A Fit Note, if required will be provided before you leave. It is anticipated that sickness absence from your employment following surgery will be approximately 4 weeks depending on individual recovery. Driving You should not drive for at least 7-14 days after your operation. Before driving again please ensure that you feel competent and safe to drive and are able to perform an emergency stop

4 You should check with your motor insurance company before resuming driving as some policies do not cover their clients for a certain length of time following surgery. Compression stockings You will need to keep the graduated compression stockings on your legs for a minimum of 24 hours both day and night until you are back to your usual level of activity. Contact Information If you have any worries or queries, please contact any of the following: The Surgical Day Case Unit 8.00am 7.00pm Monday to Friday Geddington Ward Your GP or Out of Hours service - 4 -

5 Treatment Centre Please follow the fasting instructions in your appointment letter and bring this information leaflet on the day of your operation On the day of your operation, please bring: THIS INFORMATION PACK Contact telephone number for a lift home Dressing gown and slippers Something to read or to pass the time All medication in original containers Please do not: Chew gum on the morning of your operation Bring any valuables Wear face make-up or lipstick Wear any nail varnish or false nails Wear jewellery If you have any worries or queries prior to your procedure please contact: Pre-assessment on Day Case Ward on Geddington Ward on Information checked and adjusted by: Monday to Friday 9am to 12 midday Monday to Friday 8am to 5pm Monday to Friday 24 hours and Saturday mornings Date: - 5 -

6 Instructions for patients who have had a General Anaesthetic Anaesthetic drugs may remain in the body for 24 hours gradually wearing off over this time. During the 24 hours following your anaesthetic you are under the influence of these drugs, therefore it is very important to follow these instructions: You must be taken home in a car or taxi and accompanied by a responsible adult (18 years or over). You should also have a responsible adult who will stay with you for the next 24 hours following surgery. Take things easy the day after your operation and do not participate in any strenuous exercise. Do not operate machinery and avoid using appliances such as cookers and kettles. Avoid alcohol. Be aware that smoking may cause you to feel sick and dizzy. It is advisable not to lock the bathroom or toilet door, or to make yourself inaccessible to the person looking after you in any other way. Drink plenty of fluids (at least 2 litres per day) and avoid heavy or greasy foods. You may return to your normal diet gradually as you feel able. Do not make important decisions. Do not sign important or legal documents for 48 hours. You should not be caring for young children alone. Do not drive for 48 hours following your general anaesthetic, or longer depending upon the site of the surgery. You are advised to avoid long distance journeys (3 hours or more) by any means of transport for the 4 weeks before or after your operation. If your travel is covered by insurance, you should inform your insurance company of the nature of your operation. Some people may feel slightly nauseous, tired or light-headed following a general anaesthetic but this should wear off after a few days