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Treatment of cholecystitis



26.08.2014, 14:09

Approach to treatment of cholecystitis and the choice of drugs depend on many reasons: from presence of associated diseases, how the basic disease (cholecystitis) proceeds. When choosing a method of treatment of chronic cholecystitis the existence of stones in a gall bladder, i.e. presence of cholelithiasis is crucial. If stones are – operation is necessary if it is not present – usual (conservative) treatment.

Scheme of treatment of acute cholecystitis: appoint hunger, cold (a bubble with ice) on an anterior abdominal wall, enter intravenously special solutions of the spasmolytic and anesthetizing drugs. If symptoms of a disease abate, train the patient for planned operation on removal of a gall bladder – cholecystectomia. If attacks do not stop, do operation urgently.

90% of operations are performed laparoscopically under the general anesthesia, procedure duration – 0.5-1 hour. Four punctures of a troakarama (tubes) of an abdominal wall in its upper part and around a navel with a diameter of 5 mm and 10 mm become. Special titanic clip-on earrings impose on the vessels and a channel conducting to a bubble, separate the last from a liver and take from an abdominal cavity. The operations which remained later stick punctures (5 mm) with a plaster, and 10 mm take in the resolving threads, do not remove seams. The patient is written out for the 2-4th day after intervention, the working capacity is restored in 15-20 days.

Often patients refuse surgical intervention in hope that stones will be dissolved and will leave. But dissolution of stones drugs perhaps only at their small sizes also demands two years' continuous treatment. It is possible to leave, of course, everything as it is, but the course of cholelithiasis is unpredictable. Cholecystitis is dangerous by the complications which sometimes can lead also to a lethal outcome. So the infection from a gall bladder on lymphatic channels can get to tissue of a pancreas and cause its inflammation (pancreatitis). There can be a gradual fusion of a wall of a gall bladder, at the same time the stone goes beyond its limits and forms fistula (channel, an opening). Getting to other body, it can cause its impassability, then immediate surgery will be required. Also inflammation can lead to perforation of a wall of a bubble and hit of an infection in an abdominal cavity. In this case there is peritonitis which can lead to a lethal outcome.


Malith Jur: Prof. Fink I want to thank you for your efforts to help the world have excellent Doctors tomorrow, am from S.Sudan and your lectures have helped me out during my intermediate exams however I look forwards to see you in the future if visit United States.

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Muhammad Yasir: Today we studied that edrophonium is used for diagnosis of Myesthenia Gravis and neostigmine for its treatment....... I asked a question but I wasn't satisfied with my teacher's answer Other treatment we were told was... 1=Immunoglobulins 2= immunosuppressive drugs..... Immunosuppresants are logical coz its an autoimmune disease..... but why they use immunoglobulins?

kerone brown: Thank you so much professor for your great videos.. Without, your videos it wouldnt be possible for an A in anatomy and physiology 1 and 2 .... Here to get an A in pharmacology... God bless you.

andraacram: Another way to remember symptoms is "Granny." She's Hot, Dry, Mad, Red, Blind, and Full for anticholinergic toxicity.

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