CHOLECYSTECTOMY
When is this operations required?
Cholecystectomy is required in cases of
· Symptomatic gallstones
· Traumatic or inflammatory perforation of gall bladder so as to remove gall bladder.
Position of the patient
Supine.
Anaesthesia
General.
Surgical steps
· A subcostal (right) or midline incison is given.
· The gall bladder is identified and the adhesions are divided.
· Forceps is applied to fundus and to infundibulum of gall bladder and these structures are drawn to right and forward.
· The cystic artery is divided between ligatures.
· Cystic duct is divided and between ligatures after identifying junction with common bile ducts (CBD).
· The gall bladder is divided and cut open to rule out malignancy and sent for histopathology studies.
· The abdomen is closed with suction drain is subhepatic pouch.
Instruments required
· Laparotomy set
· Gallstone probe (DesJardin)
· Gallstone forceps (DesJardin)
· Ochsner’s gall bladder trocar
· CBD dilators, Bake’s
· Kerr ‘T’ tube.
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