Successful Advanced Lap Cholecystectomy Brings Relief to 34-Year-Old Woman from Gallstones

PACE Hospitals

PACE Hospitals’ Expert Surgical Gastroenterology team successfully performed a Laparoscopic cholecystectomy for a 34-year-old female patient suffering from symptomatic cholelithiasis.

Chief Complaints

A 34-year-old female presented to the Gastroenterology Department at PACE Hospitals, Hitech City, Hyderabad, with complaints of episodic pain (intermittent pain) in the right hypochondrium (on the right side of the epigastric region (upper central part of the abdomen, located just below the ribcage and above the navel)) that had been ongoing for the last three months.

Diagnosis

Upon arrival at PACE Hospitals, the patient's vital signs were within normal limits. After a thorough physical examination, the doctors identified pain in the right hypochondrium, and diagnostic tests later confirmed symptomatic cholelithiasis.

Symptomatic cholelithiasis refers to the presence of gallstones in the gallbladder that cause symptoms, such as pain, nausea, and vomiting. These symptoms typically occur when a stone obstructs the bile duct, leading to inflammation or infection. The condition can result in episodes of biliary colic or even more severe complications like cholecystitis or pancreatitis if left untreated.

Medical Decision Making (MDM)

After consulting with the interventional and consultant gastroenterologists, Dr. Govind R. Verma, Dr. M Sudhir and Dr. Padma Priya, along with consultant Dr. Suresh Kumar S, a comprehensive evaluation was conducted to determine the most appropriate course of treatment for the patient. Their collective expertise led to the conclusion that laparoscopic cholecystectomy would be the most appropriate treatment for symptomatic cholelithiasis.

Surgical procedure

All necessary investigations were conducted, and an ultrasound of the abdomen revealed cholelithiasis. A consultation with a surgical gastroenterologist was obtained, and the patient underwent laparoscopic cholecystectomy.

During the procedure, the gallbladder was well-distended. The cardiovascular system (CVS) was found to be normal. A single artery and duct were identified, ligated, and divided.

Doctors performed laparoscopic cholecystectomy to remove the gallbladder, typically due to conditions like cholelithiasis (gallstones) or cholecystitis. Identifying and safely ligating the artery and duct during surgery prevents bleeding and ensures proper removal of the gallbladder without damaging surrounding structures.

Postoperative Care

No complications were noted following the procedure. The patient was being discharged in a hemodynamically stable condition with prescribed medications and specific instructions.

Discharge Medications

Upon discharge, the patient was prescribed antibiotics, analgesic, proton pump inhibitors (PPIs) and lactulose.

Emergency Care

The patient's guardians were advised to seek immediate admission in the Emergency Department of PACE Hospitals, Hyderabad, if they observe any symptoms such as fever, abdominal pain, or vomiting.

Review and follow-up notes

The patient was advised to schedule a follow-up appointment with Dr. Govind R. Verma in the OPD after one week.

Benefits of Laparoscopic Cholecystectomy in the Management of Symptomatic Cholelithiasis

Cholecystectomy is a surgical procedure to remove the gallbladder, usually due to gallstones, inflammation, or infection. The most common method used is laparoscopic cholecystectomy, which employs a laparoscope and specialized instruments to make small incisions in the abdomen. This minimally invasive technique results in quicker recovery, less pain, and smaller scars. It also eliminates the source of symptoms, reduces the risk of recurrent gallstone attacks, and improves the patient’s overall quality of life.

In some cases, open cholecystectomy may be required if complications arise. Performed under general anaesthesia, most patients can resume regular activities within a few weeks, though some may experience changes in digestion.