Cholelithiasis and Cholecystitis: Surgical and Nonsurgical Management

Question 1

Nonsurgical management

Answer 1

1. Infusion of a solvent mono-octanoion or methyl tertiary butyl ether (MTBE)
2. Intracorporeal Lithotripsy - use of laser pulse technology creating a mechanical shock wave
3. Extracorporeal Shock Wave Lithotripsy - uses repeated shock directed at the gallstones at the gallbladder

Question 2

Surgical management

Answer 2

1. Open Cholecystectomy
2. Laparoscopic Cholecystectomy

Question 3

Surgical Management: Pre-op care

Answer 3

1. Administer IVF therapy to replace electrolytes
2. Administer Vitamin K injection especially if prothrombin time is prolonged as per doctor’s order

Question 4

Surgical management: Post-op care

Answer 4

Patient in Low-Fowler’s position: promote lung expansion

NGT decompression: prevent gastric distention

Low fat diet for 2-3months

Encourage early ambulation after 24hrs

Encourage resume of activities within 2-3 days (Laparoscopic Cholecystectomy)

Monitor T-tube

Question 5

Nonsurgical Management

Use of laser pulse technology creating a mechanical shock wave

Answer 5

Intracorporeal Lithotripsy

Question 6

Nonsurgical Management

Uses repeated shock directed at the gallstones at the gallbladder

Answer 6

Extracorporeal Shockwave Lithotripsy