Case study on Cholecystectomy | Assignment
Added on 2020-03-01
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Running head: CASE STUDY ON CHOLECYSTECTOMYCASE STUDY ON CHOLECYSTECTOMYName of the StudentName of the universityAuthor’s note
1Case study on CholecystectomyTable of ContentsIntroduction......................................................................................................................................2Discussion........................................................................................................................................2Pathophysiology..........................................................................................................................2Patient assessment.......................................................................................................................4Prioritization of care....................................................................................................................5Discharge plan.............................................................................................................................7Conclusion.......................................................................................................................................8References........................................................................................................................................9
2Case study on CholecystectomyIntroductionThis report aims to critically analyze the case study of Mrs. Beryl Hayes, who has beenadmitted to the ward for a laproscopic cholecystectomy. Beryl has undergone a surgery and isnow still in the hospital. She has not been discharged from the hospital as no improvement isseen in her condition, and already 3 days had already passed by after the surgery. Laparoscopic cholecystectomy is usually done to remove the gall stones from the gallbladder. This process involves two methods- Open cholecystectomy and laparoscopiccholcystectomy. This report has focused on the laparoscopic method as per the given case study. This report will be discussing about the physiology and the pathophysiology of herconditions. Assessment has been done depending on the evidence based practice. The latter partof the discussion also throws light upon the type of care that has to be provided to the patient.The report also discusses about the discharge plan that has to be prepared for the patient and helphim to return to his daily activities with ease. DiscussionPathophysiologyLaparoscopic cholesystectomy is usually done to remove the gall bladder. It is usuallydone it patients, who have developed stones or infections in the gall bladder. Normally after acholecystectomy, a person is unable to go home, the same day, but is generally discharged after aone night stay. Post operative complications may arise which can extend the stay in the hospital.
3Case study on CholecystectomyA gallstone normally consists of bile saturated with cholesterol. The hypersaturation iscaused due to the greater percentage of the cholesterol concentration than its solubility. This ismainly caused due to the hypersecreation of the cholesterol metabolism (Stinton and Shaffer.2012). Loss of balance between the crystallization promoting proteins and crystallizationinhibiting proteins, leads to the formation of the cholesterol crystals with bile (Joseph et al.2012). Mucin is a glycoprotein that is secreted by the bilary epithelial cells, which has beendocumented by a pronucleating protein. The lessened degradation of mucin by the lysosomalenzymes is found to be responsible for the formation of the cholesterol crystals (Reshetnyak.2012). The Loss of motility of the gall bladder muscular wall and excessive contraction of theesphincter is also responsible for the formation of gall bladder crystals. The hypo motility of themuscular walls generates bilestasis for an extended period of time, including a lessened reservoirfunction. As the bile cannot flow, it leads to the accumulation of bile and a higher chance ofstone formation. Improper filling and a higher percentage of hepatic bile diverted from the gallbladder to the bile duct can be caused due to the hypomotility (Pasternak et al. 2013).Sometimes Gallstones are made up of bilirubin. It is a chemical that is produced due tothe breakdown of the red blood cells. Infection in the bile tract and an increased level ofenterohepatic cycle of bilirubin can lead to the formation of bilirubin stone formation. Bilirubinstones are often called as the pigmented stones (Joseph et al. 2012). As the pressure on the gall bladder increases, the organ becomes larger in size, the bloodsupply decreases and repeated inflammation leads to acute cholecystitis. Cholecystitis may alsogive rise to gall stone pancreatitis which is a life threatening condition (Joseph et al. 2012).Sometimes the gall blader can be infected with microorganisms. An inflamed gallbladder can
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