A 88 years male patients presented with end stage renal disease with coronary aery block and metastasis in the lungs. Now presents with acute cholecystitis, patients relatives needs treatments to do something
.In open cholecystectomy - After the removal of gall bladder, on table cholangiogram is done through cystic duct using water soluble iodine dye to see any stones in CBD. Using stay sutures choledochotomy is done (opened longitudinally) to remove stones in CBD. After choledochotomy, stones are removed using Des jardin's choledocholithotomy forceps. Bake's CBD dilator is used to confirm the CBD patency. - T-tube (Kehr's) is then placed in the CBD and kept for 14 days. - After 14 days a post-operative T-tube cholangiogram is done to see for free flow of dye into the duodenum, so that T-tube can be removed. ref : SRB&;s manual of surgery,3 rd ed,pg no 584
Open cholecystectomy
Tube cholecystectomy
Laproscopic cholecystectomy
Antibiotics then elective cholecystectomy
G.I.T