Belly after gallbladder removal. Diet and nutrition after gallbladder removal. Relieving the condition using alternative medicine methods

Gallbladder 08/07/2016

Dear readers, today I want to return to the very current topic of nutrition after removal of the gallbladder, despite the fact that there is quite a lot of material on the blog dedicated to this very issue. The fact is that they still write to me and ask questions, because this is very important for people who have undergone surgery, since nutrition and diet are the most important factor in recovery period after removal of the gallbladder.

In the comments to articles on the topic of gallbladder removal, people ask their questions, which Evgeniy answers competently and clearly. And I decided to cover the main aspects of nutrition after removal of the gallbladder, as well as collect the doctor’s answers to your questions in one article. Thus, each of you, dear readers, will be able to obtain the most complete information on all issues related to diet and behavior after surgery to remove the gallbladder.

Is it necessary to remove the gallbladder?

First, let's talk a little about whether the gallbladder needs to be removed. This question, I am sure, worries everyone who, based on the results of the examination, was diagnosed with gallstone disease. The upcoming operation cannot but frighten, this is a normal reaction of any person, and of course, many begin to look for alternative methods Treatments such as crushing stones or dissolving them with medications.

Crushing stones is not a safe procedure, therefore it is indicated for a very limited number of patients, and is not used often. An article is devoted to this method, which you can read if you wish.

Dissolution medicines Not all stones are susceptible, only cholesterol stones. In addition, the effectiveness of this method is determined by many factors, such as the size of the stones, their location, the absence of an inflammatory process, etc. Evgeny Snegir wrote about all this in detail in one of his articles

Therefore, you need to trust your doctor and understand that stones pose a constant threat of inflammation of the gallbladder and the development of obstructive jaundice, when a stone gets stuck in the bile duct, and this is already a threat to life.

Therefore, it is more correct to perform the operation as planned, when there is no pain, without waiting for serious complications.

Moreover, instead of abdominal surgery Nowadays, laparoscopic cholecystectomy is most often performed; this operation can reduce the length of hospital stay, minimize possible complications and, just as importantly, is less traumatic.

Why do you need a diet after gallbladder removal?

But you finally made up your mind, and your gallbladder was removed, giving fairly general recommendations to stick to a diet for the rest of your life. Is it so?

First of all, you need to understand that everything in the body functions the same as before the operation and liver cells produce bile necessary for normal digestion and cleansing the body of toxins. But if you have a gallbladder, bile accumulates in it and periodically passes into the intestine, and after cholecystectomy, bile constantly flows into the intestine through the bile ducts. Therefore, a certain diet is required that protects the intestines and does not provoke stagnation and increased secretion of bile.

A strict diet is only needed for a certain period after surgery. Over time, the functions of the gallbladder are taken over by the intrahepatic ducts and the common bile duct, and during the normal course of the postoperative period, bile stagnation does not occur, which allows a person to abandon a strict diet and switch to a normal diet with minor restrictions. This usually occurs one year after the gallbladder is removed.

Now let's talk about dietary nutrition, which allows the body to adapt to living conditions without a gallbladder and which is the basis for maintaining good health. What can you eat immediately after surgery and during the first month to one and a half months after removal of the gallbladder?

Diet and nutrition in the first days after surgery to remove the gallbladder up to 1.5 months

From three days to a week After the operation, the person spends in a hospital under the supervision of medical staff and his nutrition is organized according to all the rules necessary diet, but after discharge from the hospital, many questions regarding nutrition usually arise, which we will try to answer today.

The main task in the postoperative period is to prevent stagnation of bile, diluting it with plenty of divided drinks and eating small portions 6 - 7 times a day. It is important to establish a diet, eating at the same time, chewing food thoroughly, drinking at least 1.5 liters per day in small portions.

For 3 – 5 days You are allowed to drink unsweetened natural juices(apple, beet), fruit jelly, mashed potatoes, slightly sweetened tea. You can already eat a little vegetable soup pureed through a sieve and a vegetable omelette.

On day 5 it is already allowed to add dried White bread, but not more than 100 grams per day.

On 6 – 7 days you can eat pureed liquid porridge, pureed vegetable soups, unsweetened and low-fat cottage cheese, dairy products, lean boiled chopped meat, boiled fish, mashed potatoes, egg white omelet. It is already allowed to add dried white bread to your diet, but not more than 100 grams per day. Do not forget that nutrition and fluid intake are fractional and in small portions, this is very important.

You can drink rosehip decoction, still mineral water, which is recommended by your doctor, dried fruit jelly, sweetened tea, and natural fruit and vegetable juices. The volume of liquid can be increased to 2 liters.

From 8–10 days to 1.5 months you need to continue to follow a gentle diet, all dishes should be boiled or steamed. It can be steam cutlets, boiled meat and fish, meatballs, meatballs, souffles, milk soups and soups with vegetable broth, cottage cheese puddings, casseroles, viscous milk porridges, mashed boiled vegetables, jelly, non-acidic juices. Don’t forget about fermented milk products, which are simply necessary for the intestines. And be sure to drink water, maybe mineral water, I repeat, in consultation with your doctor.

Fresh vegetables and fruits under the strictest prohibition, as they promote bile secretion. It is also excluded Rye bread, you can only eat white and always dried or yesterday’s baked goods. Dishes should be neither cold nor hot.

You can read more about nutrition in the first days after surgery and in the first month after surgery in the article

Diet No. 5, nutrition after removal of the gallbladder from 1.5 months to a year. Recipes. Menu

In the postoperative period, when 1.5 months have passed after removal of the gallbladder, the main task is to eat foods that do not irritate digestive tract and helps dilute bile. Diet No. 5 fully meets these criteria, which you should adhere to.

The main restrictions during this period are everything spicy, fatty and fried.

And if the recovery period goes well, there is no pain or other unpleasant sensations, then the diet can be gradually expanded, but within the recommended diet, still avoiding foods that are strictly prohibited.

It is necessary to exclude from the diet:

• fatty varieties meat (pork, goose, duck),
• fatty fish,
• meat broths,
• salo,
• sausages,
• smoked meats,
• canned foods,
• salted fish,
• offal,
• caviar,
• mushrooms,
• onion garlic,
• legumes,
• radish, radish, sorrel, spinach,
• mustard, horseradish, pepper and other hot seasonings,
• fresh bread, confectionery with cream and butter dough,
• fatty dairy products,
• chocolate,
• ice cream,
• cold drinks,
• strong coffee, cocoa,
• alcohol.

The basis of the diet should be milk and vegetable soups with the addition of various cereals, crumbly porridges, boiled or steamed lean fish and meat (beef, chicken, turkey), chicken eggs, but not more than one per day. Include dairy products in your diet every day, cook cottage cheese casseroles, drink kefir, fermented baked milk and fermented milk products enriched with bifidobacteria. You can cook it as a side dish boiled potatoes, pasta, vegetable stews, cereals with the addition of a small amount of vegetable oil.

You can already afford desserts in the form of marshmallows, marshmallows, marmalade, and maybe a little honey, jam or homemade preserves for tea. You can eat dried apricots and prunes, but small quantity.

Fresh vegetables and fruits after gallbladder removal

1.5 months after the operation, you can already diversify your diet with fresh vegetables and fruits, gradually accustoming your digestive tract to them. At first, introduce fresh vegetables into the diet in chopped form, no more than 100 - 150 grams before meals. This could be carrots, zucchini, celery, small quantities of sauerkraut, tomatoes. At first, remove the skin from the tomatoes. You can add any non-acidic fruits; peel the apples.

Avoid sour varieties of apples, citrus fruits, and currants; give preference to sweet fruits and berries with delicate pulp. Watermelons are very useful, but it is better not to eat melon during the first year after surgery, it is a rather difficult product to digest.

So, let’s summarize: we exclude forbidden foods from the diet, everything fatty, fried, spicy, we take food warm, in no case hot or cold. We take food 4–5 times a day in small portions, the daily amount of liquid consumed is from 1.5 to 2 liters.

And one more very important condition: introduce new foods into your diet gradually, in small portions, carefully listening to your body’s reaction. And if some product causes you pain or discomfort in the form of bloating, belching, heartburn, it is better to give it up for now or reduce the portion. Even healthy people tolerate different foods differently, and after removal of the gallbladder you need to be very careful about your body.

What menu should you create for this time? The blog has two very detailed articles with recipes and recommended menus for this time. All recipes are described in great detail, there are quite a lot of them, you will be convinced that even dietary food can be tasty and varied. These are the articles:

Alcohol after gallbladder removal

Very often people wonder if they can afford a little on holiday alcoholic drinks. If you do not want to harm yourself, then listen to the advice of nutritionists and give up alcohol for one year after surgery. Only as an exception, 1.5 months after surgery, you can occasionally drink no more than one glass of dry or semi-dry wine on a holiday. Strong drinks are strictly prohibited.

What can you eat on holidays?

It is much more difficult when you are invited to visit, then you will have to choose, avoiding prohibited foods if possible. You shouldn’t risk your health, especially since in a year you will be able to eat nutritiously without any special restrictions. Just give your body time to learn how to function without your gallbladder.

Diet and nutrition after gallbladder removal in questions and answers

Dear readers, there are so many questions from readers on the blog, so many comments. And the doctor Evgeniy Snegir, author of the blog Medicine for the Soul, is always in touch with us. Evgeniy, I want to thank you again for such work. No comment goes unanswered.

And the questions usually start like this: “Is it possible after surgery after removing the gallbladder”..., and then comes the question - who cares? I tried to collect in one place the main questions and answers of doctor Evgeniy. I would like to hope that the structure of the answers and questions will be clear to you.

Meat, fish products, eggs

Is it possible to eat soups with meat broth after being discharged from the hospital?

In the first 1.5 months after the operation, it is better to eat vegetarian soups, but if you occasionally cook soups with weak meat broth, then there will not be much crime.

Is fish and meat baked in foil over an open fire fried and prohibited? And when can all this be introduced into the diet?

Fish and meat baked over an open fire in foil are still more related to kebabs than to dietary dishes. Therefore, it is better to postpone such goodies for a year. As an exception, 1.5 months after the operation you can pamper yourself with them on holidays, but very, very carefully.

Please tell me, is it possible to bake chicken and turkey with vegetables in the oven if only 9 days have passed since the operation? Is it even possible to cook permitted foods in pots or is it too early?

It is already possible to bake chicken with vegetables in your postoperative period, just do not add fats, add only water so that the food does not burn and there is no crust.

2. You can already make pots in the oven with approved products, again only with water.

Please tell me when it will be possible to eat red caviar, fatty fish and crab sticks?

It is better to postpone fatty fish and red caviar for a year. Occasionally, on holidays, 1.5 months after the operation you can treat yourself to a small piece of lightly salted red fish, but nothing more. Crab sticks with a proven reputation can be eaten 1.5 months after surgery.

When can you eat sushi and rolls?

How long after surgery can I eat whole eggs?

After 1.5 months from the date of surgery, you can only add egg whites to your food; after that, you can eat whole eggs for a year, but no more than one per day.

Is it possible to use meat baby food in jars as a snack during the postoperative period?

Baby food still refers to canned foods that are not recommended during the first year after surgery. Fermented milk products with white bread are quite suitable as a snack.

Fats and dairy products

How long after surgery can vegetable oil be added to food?

Vegetable oil is acceptable 1.5 months after surgery and no more than two tablespoons per day.

When can you add butter to food?

It is advisable to completely exclude butter from the diet during the first year of the postoperative period.

Is it possible to gradually add sour cream to food a month and a half after surgery?

You can already try adding sour cream to food, but not fatty, focus on how you feel.

A week has passed since the operation, please tell me what fat content of fermented milk products can be consumed and is it possible to drink acidophilus?

In the first 1.5 months after surgery, the lower the fat content of fermented milk products, the better. Acidophilus is allowed to be taken.

A week ago, my gallbladder was removed via laparoscopy. Can I now eat Tema and Agusha children's curds (they have 4-5% fat content) and drink 3.2% kefir? I suffer with bowel movements, there is no urge at all.

You can now eat baby curds and drink kefir too.

Vegetables and fruits

It's been 2 weeks since the surgery, can I eat cauliflower?

Boiled cauliflower can be eaten fresh only 1.5 months after the operation.

When can you start eating sauerkraut and homemade lecho?

Theoretically, you can start eating sauerkraut and lecho 1.5 months after the operation, but these homemade preparations can cause severe bloating (flatulence), so here you will need to focus on your own well-being. If you tolerate it well, then you eat, if it’s bad, we wait a year.

Beverages

Is it possible to drink rosehip decoction a week after surgery?

You can drink rosehip decoction and even really need it.

Is it possible to drink dried fruit compote immediately after being discharged from the hospital?

You can now drink compote and dried fruit in peace. Everything will be fine.

What mineral waters can you drink after gallbladder removal?

You can drink mineral waters; after removal of the gallbladder, Essentuki No. 4, Slavyanovskaya, Smirnovskaya, Mashuk No. 19 are suitable.

1.5 months have passed since the operation, I feel good, I am on a diet. Can I take lemon water now?

Yes, you can. Just focus on your own well-being; an exacerbation of chronic gastritis or duodenitis is possible. Therefore, if abdominal pain occurs, take lemon water It's better to stop.

Nuts, sauces

4 months have passed since the operation, can nuts and seeds be added to the diet?

You can eat a little bit of nuts and seeds, just reduce the amount of fat in your daily diet.

How long will it take to season food with soy sauce?

Dessert

A month has passed since the operation, can I eat marmalade?

Considering the great importance of marmalade, you can eat it, but in the first 1.5 months after the operation - a couple of slices and no more than twice a week.

Three weeks have passed since the operation, can I eat jam, marshmallows, and chocolate?

During your postoperative period, it will be safe to periodically consume two tablespoons of delicious jam per day. Marshmallows can be eaten 1.5 months after surgery. Chocolate is not officially recommended during the first year of the postoperative period. But if you really want it, then you can easily allow yourself two chocolates twice a week. Great harm They won’t bring any benefits, but they will noticeably improve your mood.

Cereals, bran, flour dishes

Is it possible to eat store-bought cookies and cookies with tea?

You can start eating store-bought dried biscuits no earlier than 1.5 months after surgery, but carefully and not every day. A year after the operation, within the framework of reasonable use, there will be no restrictions.

Is it possible to eat pizza during the first year after surgery?

Is it possible to eat soups and porridges made from rice and peas on the 8-9th day after removal of the gallbladder?

Soups and porridges made from rice are already possible. During the first year after surgery, legumes should be excluded from the diet.

38 days have passed since the operation, I read that bran is useful, can I use it now?

Bran can be added to food 1.5 months after surgery, i.e. in your case already in a week. Theoretically, you can take any according to your taste, but according to the experience of patients, wheat ones are best suited.

When can you eat pancakes? Or will we have to forget about them now?

You can start eating pancakes 1.5 months after surgery, but be careful; it is advisable not to use a large amount of oil in the recipe. Pancakes made with fermented milk products are very good. Pancakes can be eaten no more than twice a week.

Is it possible to cook “Extra” oatmeal 1.5 months after surgery?

If there is no tendency to constipation in the postoperative period, then you can eat “Extra” oatmeal. If you are concerned about constipation, then it is better to brew yourself a full-fledged rolled oats porridge from oatmeal.

I hope that the doctor’s answers will help you resolve your doubts and organize your diet correctly. In addition to nutrition itself, many people have questions about how to cope with nausea, how to get rid of constipation or loose stools after surgery, what to do if skin rashes appear.

Nausea after surgery

17 days have passed since the operation to remove the gallbladder. I stick to the diet, but for the last 2 days I have started to feel a little nauseous during the day. What to do about this and what could it be from?

As a rule, nausea is associated with the reflux of bile into the stomach from the duodenum. Frequent small meals and distraction therapy (a slice of lemon in tea) help in the fight against nausea. The drug “Motilium” has proven itself well, but the prescription of any drug must be agreed with a doctor after a direct examination.

I have aversions to food, nausea, a sour or metallic taste in my mouth, and problems with bowel movements. Maybe you can recommend something to increase your appetite?

Within a year, the body must adapt to new operating conditions after removal of the gallbladder and everything should return to normal.

Try to eat small portions, but often. This will allow the constantly formed bile to bind, which will normalize the stool situation. Rice, buckwheat porridge, and fermented milk products aged more than three days are good in this situation. Bananas and apples also help. Unsweetened apple juice is a good appetite stimulant.

If you don’t want to eat anything at all, then cook yourself at least a light summer vegetable soup, add grated cheese, the white of a boiled egg to taste and a spoonful of vegetable oil. Delicious, easy, nutritious!

At the pharmacy you can buy special nutritional mixtures “Nutridrink”. They With different tastes, something is sure to please!

Proven recipes from me.

(chamomile with flax seed recipe).

Normalization of stool after gallbladder removal

After removal of the gallbladder, I was tormented by constipation, help! And how long can you take laxatives?

Laxatives cannot be taken constantly, otherwise they can completely unlearn the intestines to work independently.

1. In the morning on an empty stomach, drink a glass of water at room temperature, then breakfast and go to the toilet.
2. Digestion requires fiber. Therefore, cook compotes from dried fruits (preferably including prunes). You can already eat vegetables and fruits after heat treatment: baked apples, boiled beets and carrots are good.
3. Once every five days you can perform a cleansing enema, but not more often, otherwise you can wean the intestines from working on their own. Counter enemas also help: insert 100 ml of boiled water at room temperature with a rubber bulb into the rectum before going to the toilet; you can add one tablespoon of vegetable oil to the water.
4. Movement is necessary for normal bowel function. Therefore, physical activity is required: regular morning exercises, walking.

A recipe from me, tested in practice - prunes. It should be soaked overnight in warm water, covered with a saucer and left at room temperature. In the morning, drink water and eat prunes. Accept in the system. It is enough to soak 6-8 prunes in about a glass or a little more water. Prunes can be eaten in two servings.

After the operation, despite following the diet, frequent loose stools bother me. Tell me how to deal with this?

1. Necessary frequent meals(4 - 5 times a day) in order to bind the bile constantly entering the intestines.
2. Fermented milk products aged for more than three days help (fresh ones, on the contrary, have a laxative effect).
3. Eat rice, rice and buckwheat porridge.
4. Fiber is essential, baked apples are very good.
5. In the postoperative period, you can undergo a course of treatment with drugs containing normal intestinal microflora (Linex).

Skin problems after surgery

After the operation, my mother developed acne on her face, although she never had any skin problems before the operation. Help me please

Over time, everything will return to normal; you must follow the diet and recommended drinking regimen. Courses of multivitamin preparations, for example “Vitrum” or “Alphabet”, also help. Ointments with complex effects (“Zinerit”, “Dalacin-T”) help locally. They contain antibacterial agents, apply them in a course. Skinoren gel is suitable for long-term use. But I still advise you to visit a dermatologist and coordinate the use of ointments and gels with him.

Behavior after gallbladder removal in questions and answers

In addition to nutrition, many issues are related to behavior in Everyday life after surgery on gallbladder, the answers to which I have collected for you, dear readers, in the comments to the articles. Perhaps they will help many of you overcome the difficult period of adaptation and live a normal and fulfilling life. How to live after gallbladder removal?

When can you start swimming in open water after surgery? Is it possible to sunbathe? Does water temperature matter?

It will be possible to swim in the sea and other open waters in a month, but it is necessary to avoid stress on the abs. You can actively swim no earlier than 6 months after surgery. The water temperature should be comfortable so as not to cause spastic contractions of the intestines.

It is not recommended to sunbathe on purpose for the first 6 months; in addition, you should wear a closed swimsuit in the sun (persistent pigmentation may appear in the area postoperative sutures under the influence of the sun). You can only sunbathe for 6 months after surgery.

Tell me, how long after the operation can I go to the pool for swimming?

You can engage in active swimming in the pool six months after the operation. Just splash around in the pool without heavy load You can use your abdominal muscles within a month after surgery.

Can I ride a bike or rollerblade after gallbladder removal surgery?

In a relaxed tourist mode, you can start riding a bicycle within a month after the operation. But active roller skating and cycling in sports mode can only be done 6 months after surgery, as the risk of developing postoperative ventral hernias is high.

Is it possible to exercise after removal of the gallbladder and what physical activity is acceptable?

It is possible and necessary to engage in physical exercise after removal of the gallbladder. In the first 6 months after surgery, it is advisable to avoid intense stress on the abs. As for loads, after laparoscopic cholecystectomy in the first month of the postoperative period, the permissible load is to lift no more than two kilograms of weights. After abdominal surgery in the first month - two kilograms, the second month - four kilograms. In both cases, intense stress on the abs should be avoided in the first six months.

6 months after surgery there are no special restrictions for reasonable physical activity not anymore. The only thing worth emphasizing is that professional sports are not always good for health. Therefore, a very balanced approach is needed here.

When can I start ballroom and sports dancing?

It will be possible to practice ballroom dancing within a month after the operation, and sports dancing - after six months.

4 months have passed since my gallbladder was removed, is it still possible to do yoga?

During the first year of the postoperative period, you need to choose the most soft version. In the first 6 months, it is advisable to avoid intense stress on the abs.

Is it possible to be sexually active after surgery?

Within reasonable limits, you can begin to be sexually active within a week after surgery. For the first 1.5 months, it is advisable to avoid intense sexual intercourse.

When after surgery is it permissible to undergo sanatorium-resort treatment and is it possible to fly by plane?

Sanatorium-resort treatment is possible three months after surgery. You can fly by plane.

Is it possible to take weight loss medications 4 months after gallbladder removal?

Special weight loss techniques can be practiced one year after surgery. It will be safe this way. In addition, it should be noted that strict adherence to diet No. 5, which is recommended for those who have had their gallbladder removed, usually leads to weight loss, and if you follow it, your weight problem will gradually go away.

3 months have passed since the operation. Can I do anti-cellulite massage and vacuum in the abdominal area?

You will have to wait another three months, when six months have passed since the operation.

2 months have passed since the operation, I feel good, can I go to the sauna?

Yes, you can, just be careful, don’t sit too long, focus on your own well-being.

These are the recommendations from Evgeniy Snegir and me for everyone who has undergone surgery to remove the gallbladder. And remember, the most important thing is yours positive thoughts, the attitude that everything will be fine. And, of course, it’s worth sticking to a diet, at least in the first year and a half after surgery. And such food can be tasty and varied. Health to everyone and joys of life.

And for the soul we will listen today F. Schubert. Impromptu. Op. 90 No 3 . Performed by David Frey. I really love this pianist.

see also

Gallbladder diseases. Signs, symptoms, treatment, diet 775 comments

More comments

The decision about the need for surgery is made by the doctor. As a rule, organ removal is recommended in acute cases of the disease, at stages that are not amenable to drug treatment.

Why is gallbladder removal done?

When the contractility of the gallbladder decreases or disturbances occur in metabolic processes,. Its components crystallize and precipitate. At first the particles are small (microlites), but gradually they increase in size and turn into stones. Develops, or cholelithiasis.

The disease has two course options:

1. There are stones in the gall bladder, they move, but do not interfere with the flow of bile and do not lead to inflammation.
2. Stones disrupt the flow of bile, sometimes move into the bile ducts, block them, cause inflammation and the development of infection.

In what cases is the gallbladder removed? It is not necessary to perform an operation; it is enough to observe changes in the organ and adhere to a certain lifestyle, including. The risk of complications in this case is low. But this form of the disease can be accompanied by sluggish inflammatory process, which gradually spreads to other organs. Then the patient, together with the doctor, decides on the operation.

If the outflow of bile is disrupted, inflammation develops, and then infection, then it is almost impossible to eliminate the problem without surgical intervention. An operation to remove the gallbladder is performed in order to prevent attacks of cholecystitis - accompanied by acute pain, nausea, vomiting.

Besides, acute course disease leads to complications. There is a risk of spread of inflammatory and infectious processes to the liver and abdominal cavity. The patient may develop reactive hepatitis, cholangitis, peritonitis, intestinal obstruction. Pus accumulates in the gallbladder, inflammation intensifies, an abscess covers nearby tissues, and sometimes gangrene or perforation develops in the walls of the organ.

Stages and process of procedure behavior

The gallbladder can be removed during open cholecystectomy or laparoscopy. The first option has a wider list of indications, but it is more traumatic. The second one does not require an abdominal tissue incision, but in some cases it cannot be applied (for example, when acute inflammation or adhesions). The choice of method is made by the doctor based on the characteristics of the disease and its complications.

Many patients are concerned about how long the surgery to remove the gallbladder lasts. In both cases, the procedure takes from 30 to 90 minutes. Most often, its duration is 1 hour.

Open cholecystectomy is performed under general anesthesia.

During the operation, the doctor performs the following steps step by step:

1. Performs an incision (15-30 cm) in the area of ​​the right hypochondrium or midline abdomen from the sternum to the navel.
2. Ligs the gallbladder using surgical thread.
3. It compresses vessels and ducts with special clips.
4. The gallbladder is cut off with a scalpel and removed.
5. Checks for the presence of stones in the bile ducts.
6. Sews up the incision, bringing the catheter out (to remove exudate).

Laparoscopic surgery is also performed under general anesthesia.

1. A special instrument (trocar) makes 3-4 punctures in the navel area and slightly higher, to the right.
2. A probe with a camera is inserted into one of the trocars, the image is displayed on the monitor, and the doctor is able to monitor his actions.
3. He inserts clamps through the trocars and places them on the vessels and bile duct.
4. Cuts off the gallbladder.
5. If the size of the bladder does not allow it to be removed through the hole, then the doctor first removes and removes the stones, and then the organ itself.
6. Ultrasound, laser or coagulation stops bleeding.
7. He sews up large holes and wounds, seals small ones with adhesive tape.

The surgeon works in a team; some actions can be performed by assistants. The progress of the operation is saved in video format.

Sometimes gallbladder removal is performed on a paid basis; the price of the operation depends on the level of the clinic, region, and the qualifications of the surgeon. On average, it ranges from 20 to 35 thousand rubles, but in in some cases could be much higher.

Postoperative period

When the gallbladder is removed, the patient has many questions about the recovery period, for example, what medications to take, how long to stay in the hospital, and when it will be possible to return to their normal lifestyle.

After open cholecystectomy, the sutures are removed after 6-8 days, and discharge from the hospital occurs on days 10-14, depending on the patient’s condition. You will be able to return to your normal work schedule after 1-2 months.

After laparoscopy, there is no need to remove sutures; you are discharged from the hospital after 2-4 days. After 2-3 weeks you can return to your previous activity.

The recovery period after any type of surgery includes, comfortable mode activities, conducting massage courses. As for medications, it is sometimes necessary to take mild choleretic drugs.

Complications after surgery

Surgery always carries a risk of complications. Any operation is traumatic, after which problems may arise such as slow healing of wounds, their suppuration, peritonitis, bleeding, internal abscess. Fortunately, the percentage of development of such complications is small.

What else are the risks of removing the gallbladder? Among the most common complaints of patients are pain in the right side, in the liver and stomach, and stool disorders.

Liver pain

For the most part the liver is located with right side: from the diaphragm (nipple level) to the lower edge of the ribs. For one and a half months after the gallbladder is removed, the liver may hurt. If the sensations are tolerable and are not accompanied by other symptoms, then this is normal. In this way, the body adapts to the changes that have occurred. If nausea, vomiting, fever, or digestion problems occur, you should consult a doctor.

After surgery, the liver still produces bile. Most often, it goes directly into the intestines, but in some cases, when the gallbladder is removed, the bile ducts can become clogged with secretions, causing symptoms of cholestasis to develop: Blunt pain in the right hypochondrium, yellowness of the skin and sclera, nausea, bitterness in the mouth, lethargy, drowsiness.

If the gallbladder is removed and the liver hurts, this is confirmed by the results of a biochemical blood test and treatment is prescribed: taking drugs with hepatoprotective and choleretic effect(Essentiale, Liv 52, etc.). Gradually, the body adapts to the changes, and the intrahepatic ducts partially replace the gallbladder without pain.

Pain in right side

After the gallbladder is removed, patients often experience pain on the right side.

This symptom can be caused by several reasons:

1. Damage to soft tissue during surgery and subsequent inflammation. Even with laparoscopy, wounds cannot be avoided; until they are completely healed, pain may be felt in the right side.
2. Adaptation of the digestive system to changed conditions. The pain is mild, does not require treatment, and disappears after 1-1.5 months.
3. Development of new and exacerbation of chronic organ diseases gastrointestinal tract : pancreatitis, hepatitis, spasm bile ducts, biliary dyskinesia, etc.
4. Dietary disorder. Digesting spicy, fatty, too sour or salty foods requires a lot of bile. Since the gallbladder is no longer there, the body cannot provide it in sufficient quantities. Digestive disorders manifest themselves as pain.
5. Residual stone– the cause of biliary colic when the gallbladder is removed. During the operation, a small stone in the duct may go unnoticed. Subsequently, its displacement causes pain.

In order to determine what exactly caused the pain in the right side, you need to consult a doctor. He will conduct an examination and, if necessary, prescribe treatment.

Stomach ache

When the gallbladder is removed, patients often complain of stomach pain. This unpleasant symptom is associated with changes occurring in the digestive system. After the operation, bile does not accumulate, and therefore its consistency and composition change: it becomes liquid, less active against pathogenic microflora, but aggressively affects the mucous membrane of the duodenum.

As a result, the motility of this section is disrupted, and food masses are thrown back into the stomach cavity and into the esophagus. Pain appears, enteritis develops. This condition requires consultation with a gastroenterologist.

Stool disorder

When the gallbladder is removed, digestive disorders may appear, which are often manifested by loose stools, less often by constipation. Diarrhea develops due to the rapid passage of bile acids through the duodenum and stimulation of the production of digestive juice ahead of time.

Another reason for loose stools is a violation of the intestinal microflora. As noted earlier, bile becomes less concentrated and has a worse effect on pathogenic microflora. The situation is aggravated by a decrease in the body’s immune forces due to the operation. Bacterial overgrowth syndrome develops, accompanied by periodic diarrhea, bloating and flatulence.

The reason after removal of the gallbladder is most often a decrease in the amount of food consumed and the lack of fiber products in it. Therefore, it is important to follow the recommended diet and water regime.

Nutrition after surgery

After removal of the gallbladder, the functioning of the gastrointestinal tract changes. If previously the release of bile occurred after food intake, now it flows constantly in small portions. This leads to irritation of the mucous membrane, inflammation, and impaired motility of the duodenum. Changes in the composition of bile also negatively affect the process of digestion of food.

Correcting your diet helps you avoid many digestive problems and diseases of the gastrointestinal tract.

The general rules are:

• During the day you need to drink about 2 liters of water, including 1 glass before each meal.
• All food and drinks should be taken warm, the optimal temperature is about 35-40° C. Hot and cold are prohibited.
• To ensure that bile is removed from the body and does not irritate the intestinal mucosa, you need to eat as often as possible, 5-7 times a day. Portions may be small.
• Cooking and stewing are permitted methods of cooking. When frying, compounds are formed in the dish that provoke intense secretion of gastric juice, which leads to irritation of the mucous membrane and disruption of its functioning.

After removal of the gallbladder, you will have to give up strong coffee and tea, soda and alcohol, most sweets, legumes, mushrooms, sausages, canned food and smoked meats. All foods high in animal fat are prohibited: some types of fish, poultry, meat, lard. When preparing dishes, you should not add spices (especially hot ones), onions and garlic. Use salt to a minimum; it is best to add it to already prepared food.

• soups based on vegetable, fish or low-fat meat broth;
• fish, poultry, beef or veal, steamed, boiled or stewed;
• Buckwheat and oatmeal are the most preferred side dishes; semolina should be avoided;
• for dessert you can prepare baked or stewed fruits;
• stewed, steamed or boiled vegetables;
• cottage cheese 9% fat, kefir, yogurt, fermented baked milk, bifidok - always fresh.

This diet is called “Table No. 5”. It is designed specifically for patients with liver and gallbladder diseases. 2 months after the operation, fats can be introduced into the diet: vegetable oils, small amounts of butter and sour cream. If you want something sweet, you are allowed to eat a little honey, marshmallows, marmalade, and dry cookies, but all this should be without cocoa, chocolate, nuts or seeds.

Medicines are not effective enough because they are unable to eliminate stones. Surgery to remove the gallbladder can be performed traditionally (open cholecystectomy) or laparoscopically. The second option is less traumatic, but in some cases cannot be used.

When a person has his gallbladder removed, he has a question: how to live after the operation? Activity restrictions will need to be observed for 1.5-2 months. A diet that helps the digestive organs adapt to changes - about a year. Otherwise, you don’t have to change your lifestyle.

Useful video about nutrition after gallbladder removal

When doctors insist on cholecystectomy, many patients wonder what their life will be like without a gallbladder. Most often, such a measure may be necessary only in situations where other methods of treating gallbladder pathologies are ineffective and otherwise the consequences could be quite dire. Today, this is the most common operation performed on the abdominal organs.

The role of the gallbladder in human life and its pathology

The gallbladder (GB) plays the role of a kind of storage of bile produced by the liver to ensure digestion processes. Bile accumulates in the bile organ, becomes more concentrated and is released into the duodenum when partially digested food enters the intestines, where processing and breakdown of food continues into useful microelements, vitamins and fats that enter the blood to further nourish the human body.

In the event of certain diseases of the gastrointestinal tract, a radical solution to the issue is required, namely, the removal of this organ.

The main ailments requiring removal of the bile organ:

As medical statistics show, it is quite possible to live without a gallbladder. There are often cases when a person after surgery has a full life, provided that the principles are followed proper nutrition and avoidance of harmful foods and alcohol. And yet certain changes occur in the body.

There are 3 types of basic transformations:

1. Changes in intestinal microflora due to insufficient concentration of bile coming from the liver. The number of bacterial species living in the intestinal system increases.
2. Intracavitary pressure on the hepatic ducts increases.
3. Bile does not accumulate, as before, in the bladder and flows out of the body, going directly from the liver to the intestines.

Because of bile juice no longer going to required volumes in storage, and continuously flows into the duodenum; if you eat fatty foods, there is a lack of bile. As a result, the process of digestion of food slows down and worsens, causing stool disturbances, excessive gas formation, signs of indigestion and nausea. As a result, a person experiences a deficiency of many substances: essential fatty acids, vitamins A, E, D and K, various antioxidants (lycopenes, luteins and carotenoids) contained in vegetables.

If the bile produced by the liver is too caustic, then there is a possibility of damage to the intestinal mucous walls, which provokes the formation cancerous tumors. Therefore, after removal of the gallbladder, the main task of doctors is to prescribe corrective treatment that normalizes the chemical composition of bile juice.

What may bother a person in the first postoperative days?

The process of rehabilitation of the patient depends on the method by which cholecystectomy was performed. With laparoscopic removal, the patient recovers within 10–14 days. When removing the bubble conservative method The body will recover in 6–8 weeks.

The main symptoms of concern during this period:

1. Nagging pain at the surgical site, which can be relieved by taking painkillers.
2. Nausea as a consequence of anesthesia or other drugs, which passes quickly.
3. Pain in the abdominal area, radiating to the shoulders, in the event of gas being introduced into the abdominal cavity during laparoscopy. They disappear after a few days.
4. Due to lack of bile, gases accumulate in the stomach and loose stool. Symptoms may persist for several weeks. A diet is required to ease the load on the liver.
5. Fatigue, mood swings and irritation due to impotence.

These manifestations disappear as the person recovers and have no effect on vital functions.

Special diet

Diet therapy is one of the most important conditions for quick recovery the patient and his future life activities. Already on the 2nd day after surgery, low-fat broths, weak tea and mineral water. On day 3 they add to the menu fresh juices, fruit purees, soups and kefir. In the future, you can diversify your food, avoiding fatty foods.

To restore the activity of the biliary tract, diet No. 5 is prescribed, which involves limiting fat consumption and increasing the amount of protein and carbohydrates.

To avoid intestinal disorders, split meals in small portions are recommended. The diet should consist of lean poultry or fish, low-fat dairy products, cereals (rice, oatmeal, semolina), steamed vegetables (carrots, cauliflower, tomatoes), and fresh fruits. Food must contain a large number of fiber, providing normal work intestines. Dishes must be boiled or steamed.

In most cases, after 4-5 weeks the person returns to their usual way of eating, but some patients are forced to follow a diet for months or years.

Gymnastics and physical activity

To prevent bile from stagnating in the liver, walking is allowed. fresh air, in a few months you can go swimming. Light exercise in the morning and gentle skiing in winter are encouraged. Must be avoided heavy loads, affecting the abdominal muscles to avoid the formation of hernias. People with overweight must wear special bandages.

Do not lift heavy objects (no more than 5–7 kg). You can return to work 7–10 days after the operation, if it is not accompanied by physical activity. Sexual activity can be resumed 2 weeks after surgery.

Traditional methods

Decoctions are effective for strengthening and cleansing the liver of toxins and waste, improving the production of healthy bile medicinal herbs- sorrel root, turmeric, milk thistle, green tea. However, all means traditional medicine can have side effects Therefore, they should be used as prescribed by a doctor.

Possible undesirable consequences after removal

Complications in the absence of GB are conventionally divided into early and late. The first include those that arose after surgery. Among them:

• infections acquired during intervention or wound treatment, accompanied by painful sensations, swelling and redness of the operation site, purulent inflammation of the sutures;
• bleeding caused by various reasons(poor clotting, damage to blood vessels, etc.);
• leakage of bile secretion into the abdominal cavity, causing abdominal pain, fever and swelling;
• violation of the integrity of the intestinal walls and blood vessels;
• blockage of large deep veins.

Complications that occur over later, are called postcholecystectomy syndrome (PCES) and are characterized by the following symptoms:

• attacks of nausea and vomiting, especially after consumption fatty foods;
• heartburn due to reflux pathology of the stomach when undigested food And gastric juice are thrown into the esophagus or due to the development of reflux gastritis - the reflux of bile from the duodenum into the stomach;
• increased gas formation and loose stools;
• pain in the right side;
• the skin and mucous membranes acquire a yellowish tint;
• increased fatigue;
• itching of the skin;
• formation of rock deposits in biliary tract, which occur when bile stagnates and can cause blockage of the ducts;
• inflammatory processes in the bile ducts - cholangitis;
• liver damage (hepatitis) or pancreatitis, resulting from impaired outflow of bile secretions.

Late sequelae may occur depending on presentation in 5–40% of postoperative cases.

Pregnancy without gallbladder

In some cases, the problems are not only how to live without a gallbladder, but also how to bear a child in the absence of this organ. Directly related to conception and birth healthy child cholecystectomy does not. However, while expectant mothers are waiting for the birth of their baby, the following symptoms may occur due to: bile stagnation, - itching of the skin, increased acidity. Antioxidants are prescribed to relieve symptoms, vitamin complexes and antiallergic drugs.

In addition, the likelihood of stone formation in the bile ducts increases during pregnancy or even some time after childbirth, which is due to poor diet and decreased immunity. expectant mother. It is important to remember that a removed gallbladder cannot be a contraindication for having a child, but such patients should be under close supervision. It is necessary to take all measures to prevent the development of jaundice in mother and baby.

Is it possible to drink alcohol?

In the initial period after surgery, drinking strong drinks is contraindicated, since alcohol cannot be combined with certain medications. It is not recommended to drink alcohol until the body has fully recovered and switched to a normal diet.

In a healthy body, the liver absorbs ethyl alcohol, processes it and secretes it into bile secretion. These products are usually neutralized in the gallbladder. In the absence of gallstones, the products of alcohol processing and a large amount of bile enter directly into the intestines, causing irritation, nausea, vomiting, a bitter taste in the mouth, and stool disturbances.

In addition, alcohol can provoke re-formation of stones in the bile ducts, pancreatitis, and cirrhosis of the liver. In most cases, many patients develop alcohol intolerance after removal of the bile organ.

Advantages and disadvantages of cholecystectomy

Based on the above, we can say that the absence of a gallbladder has its own inherent pros and cons. Removal of this organ itself is recommended only in extreme cases, in case of dangerous pathologies and the presence of a threat to the patient’s life. Most patients return to normal full life, but in in rare cases Various complications develop that limit the quality of life.

Positive aspects of the operation:

1. A balanced diet allows you to improve your lifestyle by improving the health of the gastrointestinal tract and the entire body as a whole - the complexion improves, and a feeling of lightness appears.
2. Refusal of fatty foods, dietary nutrition help to lose overweight, improving a person’s external attractiveness and facilitating the functioning of internal organs.
3. Removing the gallbladder allows you to avoid many undesirable consequences, including organ rupture and death.
4. The operation does not affect reproductive functions, libido and potency, or life expectancy.
5. You can live without fear of gallstone disease, you are not bothered by pain in the right side, signs of dyspepsia and other undesirable conditions.
6. Possibility of returning to a full life.

Disadvantages of living without a bile organ:

1. Diet therapy at the initial stages requires certain efforts - adherence to an hourly meal schedule, selection of special products, and separate preparation of food for the patient.
2. The natural mechanism for digesting food is disrupted.
3. If a person lives without a gallbladder, in some cases there is heartburn, nausea, and a bitter taste in the mouth for a long time.
4. There is no accumulation of bile and improvement of its composition.
5. Uncontrolled release and constant flow of bile substance into the duodenum, the possibility of its irritation by excessively “aggressive” bile.
6. Intestinal imbalance, intestinal motility disorder (either constipation or diarrhea), prolonged and uncomfortable adaptation to a new lifestyle and diet.
7. Risk of complications.

Thus, it is possible to live without a gallbladder, but only if you follow proper nutrition, limit the consumption of alcohol and follow all medical prescriptions.

Inna Lavrenko

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According to clinical trials The presence of a number of diseases in patients causes gallstones. The process of stone formation can begin after natural reasons in the form of an unhealthy lifestyle or eating junk food. In some cases, drug therapy does not bring the expected effect and it is necessary to resort to surgical intervention, especially if the situation is complicated by attacks of biliary colic.

Once cholecystectomy is completed, the person begins new life, without gallbladder. Frequent companions even after a successful operation they become unpleasant symptoms and general discomfort, as complications develop in the digestive system and intestinal tract.

All complications are dangerous in their own way and can significantly worsen the patient’s life. The most severe is postcholecystectomy syndrome, which occurs in approximately 10% of all cases of surgery. Of this number, about a third are caused by remnants of stones in the biliary system, ducts or liver.

Symptoms appear after some time in the form of colic, yellowing of the skin or pain in the sides, usually on the right side. They can be treated conservative scheme or repeated operation, which is resorted to only in emergency cases when drug therapy in treating the cause is ineffective. Repeated intervention is more dangerous than the first and can only help in 79% of cases. But if you refuse, you can get a serious complication and possibly death.

What consequences can be expected with concomitant diseases?

Symptoms after gallbladder removal should be alarming if they do not go away or get worse. This applies to pain and nausea, fever, which often occurs during exacerbation of the patient’s chronic diseases. Therefore, before the operation it is prescribed comprehensive examination organism to differentiate symptoms after cholecystectomy.

A number of diseases are exacerbated by the loss of the gallbladder: pathologies in the bile excretion pathways, the presence of reflux, diseases in the pancreas, liver pathologies, hepatitis and malfunction of the sphincter of Oddi.

Pain due to surgery

Experts note that after surgery to remove the gallbladder, signs of pain in the abdominal cavity appear. This sometimes happens due to the nuances of the intervention of surgeons and equipment. Pain is localized at the site of the remote bile organ where the scar is located. The intensity of the manifestation depends on the individual pain threshold patient. The duration varies from several hours to 3-4 days after cholecystectomy. The method of performing the intervention determines the terms of rehabilitation; in the case of laparoscopy, recovery is less painful and occurs faster than after laparotomy.

Biliary peritonitis

Sometimes after a successful cholecystectomy, doctors detect the presence of bile in the peritoneal cavity. The patient complains of fever and vomiting, severe pain near the navel, and there is also chills with profuse sweating. These symptoms indicate biliary peritonitis, which must be urgently eliminated.

Diarrhea

Intervention with the removal of the gallbladder disrupts the functioning of the gastrointestinal tract, which affects both the digestive system and the functioning of the intestinal tract. Symptoms vary in intensity and prevalence. Among the manifestations there is severe diarrhea, intense gas formation in the abdomen, bloating and distension of the peritoneum. A fifth of patients develop bloody diarrhea and heat. Medicines and a strict diet are prescribed as therapy. Sometimes diarrhea persists for several years, a phenomenon called hologenic diarrhea.

A sign of hologenic diarrhea is light-colored stool or an admixture of bile green streaks, pain in the right side. The disease does not show positive dynamics in therapy and can last for quite a long time, dehydrating the body and provoking the development of jaundice. Frequent vomiting makes the situation worse.

Heartburn

Before removal of the bile organ, bile secretion from the liver entered the storage tank, increased its concentration in it and was released at the time of food intake. This is how fats and other useful substances that passed through the esophagus were broken down. After removal of the bile organ, the composition of the bile changes and becomes less concentrated. Release into the intestines occurs constantly, due to which the substance becomes liquid.

Over time, the emissions become more and more, the pressure in the bile ducts increases, which greatly complicates the work of the sphincter located at the bottom of the esophagus. The patient experiences frequent belching, severe and sharp pain, unpleasant bitter taste in the mouth. Heartburn requires treatment, since the amount of bile produced in the gastrointestinal tract constantly increases, and excess cholesterol, acid and microelements are formed. In this case, liver tissue may be damaged.

How to live with a removed biliary organ?

Removal of the gallbladder makes adjustments to a person’s lifestyle. After undergoing surgery, the patient must change his diet and regimen to give the body the opportunity to adapt.

Proper and healthy nutrition

Changing eating habits for gallbladder diseases does not depend on cholecystectomy, but is prerequisite proper completion of the rehabilitation period. This will help avoid the development of the syndrome after surgery, neutralize the effect of bile acids on the vulnerable walls of the intestinal tract and stomach, and improve the outflow of bile. The doctor gives tables of permitted and prohibited foods that must be eaten in small portions. It is forbidden to take food that is too hot or frozen, as this provokes spasms in the ducts.

If you drink a little still water before meals, you can protect the mucous surfaces in the gastric tract from the effects of bile acid.

Experts strongly recommend that patients without a gallbladder go swimming, no matter whether it is a pool or an open natural body of water. Water gently massages the abdominal cavity and improves the movement of bile. You can start swimming only 2-3 months after surgery. To prevent stagnation, you need to walk more often, do regular exercises without loading your abs.

Walk

Diagnostics according to schedule

In order not to miss the onset of stone formation in the biliary system, it is recommended to mandatory donate bile to biochemical research in a clinic or hospital laboratory. When collecting bile samples, place them in the cold for 12 hours to determine the presence of sediment. If thickening and sedimentation occurs, this is a symptom of the onset of stone formation.

Drug therapy

Treatment with drugs after a removed organ is minimal. The gallbladder did not produce bile, but only accumulated it. Immediately after the intervention, it is necessary to take a course of antibiotics, and in the first days a forced antibacterial therapy. Such measures will help avoid the development of complications.

Is it possible to get pregnant without a gallbladder?

Removal of the biliary storage does not affect the reproductive ability of women. Moreover, in 85% of cases there are no disorders in the organs of other systems. When the gallbladder organ is removed, problems in the digestive process may occur, as well as early and severe toxicosis, during which the symptoms resemble postcholecystectomy syndrome. A woman may experience pain under the costal arches in the right side of the abdomen, heaviness in the abdomen and constant heartburn or nausea, which is often attributed to the patient’s condition. Medicines will help relieve discomfort.

Pathologies developing in the biliary tract are a factor in the disruption of pregnancy. Removing the bladder slightly reduces this rate, but the complications become more severe. Prolonged toxicosis is observed, up to the 29th week of pregnancy. The patient takes some medications that affect the development and formation of the fetus. In this regard, doctors advise to refrain from conceiving for six months. After the intervention, the body is under severe stress, which is fraught with premature birth. If the expectant mother has problems with the biliary system and the quality of bile, then the child has an increased risk of developing jaundice.

In some cases, cholecystectomy becomes a factor leading to disability. A special commission of medical experts evaluates several parameters before making a decision.

The first disability group is issued for people with moderate disabilities. These include fistulas after removal of the gallbladder or inflammatory calculous forms of diseases;

The second disability group includes patients with severe complications in the digestive system, as well as with serious metabolic failure. This category also includes patients who have suddenly lost a large amount of body weight, as well as those with problems with the production of bile in the liver;

The third disability group includes patients with significant limitations in activity. This may be cachexia or anemia, which greatly depletes the body. This also includes those people who were not helped by any treatment proposed by doctors. Such patients require constant special care.

Conclusion

Removal of the gallbladder can provoke the development of many diseases new to the body, or aggravate existing chronic ones. But in any case, it is necessary to radically change your usual diet and lifestyle, add activity, take medications and undergo regular examinations.

Regarding female patients, there is no need to be afraid of complications during pregnancy after cholecystectomy. If there were no violations of the rehabilitation regime, then after six months you can begin to conceive.

Many patients are concerned about the question of how to live after removal of the gallbladder. Will their lives be as fulfilling, or are they doomed to disability? Is it possible to full recovery after gallbladder removal? There are no unnecessary organs in our body, but they are all conditionally divided into those without which further existence is simply impossible and those in the absence of which the body can function

The process in which the gallbladder is removed is a forced procedure; it is a consequence of the formation of stones and a malfunction in the body, after which the gallbladder ceases to function normally. Stones that appear in the gall bladder begin to form as a result of chronic cholecystitis.

Diet after gallbladder removal will prevent the occurrence of postcholecystectomy syndrome.

The postoperative period is a stay in the hospital.

After a routine uncomplicated laparoscopic cholecystectomy, the patient is admitted from the operating room to the department intensive care, where he spends the next 2 hours of the postoperative period to monitor adequate recovery from the state of anesthesia. In the presence of concomitant pathology or characteristics of the disease and surgical intervention, the duration of stay in the intensive care unit may be increased. The patient is then transferred to a ward where he receives the prescribed postoperative treatment. During the first 4-6 hours after surgery, the patient should not drink or get out of bed. Until morning next day You can drink after surgery plain water without gas, in portions of 1-2 sips every 10-20 minutes with a total volume of up to 500 ml. The patient can get up 4-6 hours after surgery. You should get out of bed gradually, first sit for a while, and, in the absence of weakness and dizziness, you can get up and walk around the bed. It is recommended to get up for the first time in the presence of medical personnel(after a long stay in horizontal position and after the action of medications is possible orthostatic collapse- fainting).

The next day after the operation, the patient can move freely around the hospital and begin taking liquid food: kefir, oatmeal, diet soup and return to your normal fluid intake regimen. In the first 7 days after surgery, the consumption of any alcoholic beverages, coffee, strong tea, drinks with sugar, chocolate, sweets, fatty and fried foods. The patient's diet in the first days after laparoscopic cholecystectomy may include fermented milk products: low-fat cottage cheese, kefir, yogurt; porridge with water (oatmeal, buckwheat); bananas, baked apples; mashed potatoes, vegetable soups; boiled meat: lean beef or chicken breast.

In the normal course of the postoperative period, the drainage from the abdominal cavity is removed the next day after surgery. Removing the drain painless procedure, is carried out during dressing and takes a few seconds.

Patients young, after surgery for chronic calculous cholecystitis, they can be sent home the next day after surgery, the remaining patients are usually in the hospital for 2 days. Upon discharge, you will be given a sick leave certificate (if you need one) and an extract from the inpatient card, which will outline your diagnosis and features of the operation, as well as recommendations on diet, exercise and medication. Sick leave issued for the duration of the patient's stay in the hospital and for 3 days after discharge, after which it is necessary to extend it with the surgeon of the clinic.

The postoperative period is the first month after surgery.

In the first month after surgery, functions are restored and general condition body. Careful adherence to medical recommendations is the key to full recovery of health. The main directions of rehabilitation are compliance with physical activity, diet, drug treatment, wound care.

Compliance with physical activity regimen.

Any surgery accompanied by tissue trauma and anesthesia, which requires restoration of the body. The usual rehabilitation period after laparoscopic cholecystectomy ranges from 7 to 28 days (depending on the nature of the patient’s activity). Despite the fact that 2-3 days after the operation the patient feels satisfactory and can walk freely, walk on the street, even drive a car, we recommend staying at home and not going to work for at least 7 days after the operation, which is required for the body to recover. . At this time, the patient may feel weakness and increased fatigue.

After surgery, it is recommended to limit physical activity for a period of 1 month (do not carry weights exceeding 3-4 kilograms, exclude physical exercise, requiring tension in the abdominal muscles). This recommendation is due to the peculiarities of the formation of the scar process of the muscular aponeurotic layer abdominal wall, which reaches sufficient strength within 28 days from the date of surgery. 1 month after surgery there are no restrictions on physical activity.

Diet.

Compliance with the diet is required for up to 1 month after laparoscopic cholecystectomy. It is recommended to exclude alcohol, easily digestible carbohydrates, fatty, spicy, fried, spicy food, regular meals 4-6 times a day. New foods should be introduced into the diet gradually; 1 month after surgery, dietary restrictions may be lifted on the recommendation of a gastroenterologist.

Drug treatment.

Minimal medical treatment is usually required after laparoscopic cholecystectomy. Pain syndrome after surgery is usually mild, but some patients require the use of analgesics for 2-3 days. Usually these are ketanov, paracetamol, ethol fort.

In some patients, it is possible to use antispasmodics (no-spa or drotaverine, buscopan) for 7-10 days.

Taking ursodeoxycholic acid (Ursofalk) can improve the lithogenicity of bile and eliminate possible microcholelithiasis.

Taking medications should be carried out strictly as directed by the attending physician in an individual dosage.

Care of postoperative wounds.

In the hospital, special stickers will be applied to postoperative wounds located at the places where instruments are inserted. It is possible to take a shower with Tegaderm stickers (they look like a transparent film), while Medipore stickers (a white patch) must be removed before showering. You can shower starting 48 hours after surgery. Getting water on the seams is not contraindicated, but you should not wash the wounds with gels or soaps or rub them with a washcloth. After taking a shower, you should lubricate the wounds with a 5% iodine solution (or Betadine solution, or brilliant green, or 70% ethyl alcohol). Wounds can be treated using the open method, without dressings. Taking baths or swimming in pools and ponds is prohibited before the sutures are removed and for 5 days after the sutures are removed.

Sutures after laparoscopic cholecystectomy are removed 7-8 days after surgery. This outpatient procedure, the removal of sutures is carried out by a doctor or a dressing nurse, the procedure is painless.

Possible complications of cholecystectomy.

Any operation may be accompanied by undesirable effects and complications. Complications are possible after any cholecystectomy technology.

Complications from wounds.

These may be subcutaneous hemorrhages (bruises) that go away on their own within 7-10 days. Special treatment not required.

There may be redness of the skin around the wound and the appearance of painful lumps in the wound area. Most often this is due to wound infection. Despite the ongoing prevention of such complications, the frequency wound infection is 1-2%. If similar symptoms You should consult a doctor as soon as possible. Late treatment may lead to wounds that become suppurated, which usually requires surgical intervention. local anesthesia(sanitation of a festering wound) followed by dressings and possible antibiotic therapy.

Despite the fact that our clinic uses modern high-quality and high-tech instruments and modern suture material, in which the wounds are sutured cosmetic stitches However, in 5-7% of patients, hypertrophic or keloid scars may form. This complication is associated with the individual characteristics of the patient’s tissue reaction and, if the patient is dissatisfied cosmetic result may require special treatment.

In 0.1-0.3% of patients, hernias may develop at the sites of trocar wounds. This complication is most often associated with features connective tissue patient and may require surgical correction in the long term.

Complications from the abdominal cavity.

Very rarely, complications from the abdominal cavity are possible, which may require repeated interventions: either minimally invasive punctures under ultrasonography guidance, or repeated laparoscopies or even laparotomies (open operations on the abdominal cavity). The frequency of such complications does not exceed 1:1000 operations. It can be intra-abdominal bleeding, hematomas, purulent complications in the abdominal cavity (subhepatic, subphrenic abscesses, liver abscesses, peritonitis).

Residual choledocholithiasis.

According to statistics, from 5 to 20% of patients with cholelithiasis also have accompanying stones in the bile ducts (choledocholithiasis). A set of examinations carried out in the preoperative period is aimed at identifying such a complication and using adequate treatment methods (this can be retrograde papillosphincterotomy - dissection of the mouth of the common bile duct endoscopically before surgery, or intraoperative revision of the bile ducts with removal of stones). Unfortunately, none of the methods of preoperative diagnosis and intraoperative assessment is 100% effective in identifying stones. In 0.3-0.5% of patients, stones in the bile ducts may not be detected before and during surgery and cause complications in the postoperative period (the most common of which is obstructive jaundice). The occurrence of such a complication requires endoscopic (using a gastroduodenoscope inserted through the mouth into the stomach and duodenum) intervention - retrograde papilosphinctoromy and transpapillary sanitation of the bile ducts. In exceptional cases, repeated laparoscopic or open surgery is possible.

Bile leakage.

Bile leakage through drainage in the postoperative period occurs in 1:200-1:300 patients; most often it is a consequence of the release of bile from the gall bladder bed on the liver and stops on its own after 2-3 days. This complication may require an extended hospital stay. However, bile leakage through drainage can also be a symptom of damage to the bile ducts.

Damage to the bile ducts.

Damage to the bile ducts is one of the most severe complications in all types of cholecystectomy, including laparoscopic. In traditional open surgery, the incidence of severe bile duct injury was 1 in 1500 operations. In the first years of mastering laparoscopic technology, the frequency of this complication increased 3 times - up to 1:500 operations, however, with the growing experience of surgeons and the development of technology, it stabilized at the level of 1 in 1000 operations. Famous Russian specialist on this problem, Eduard Izrailevich Galperin wrote in 2004: “... Neither the duration of the disease, nor the nature of the operation (emergency or planned), nor the diameter of the duct and even the professional experience of the surgeon affect the possibility of damage to the ducts...”. The occurrence of such a complication may require repeated surgery and a long period of rehabilitation.

Allergic reactions to medications.

trend modern world is an increasing increase in allergenicity of the population, therefore allergic reactions to medications (relatively mild - urticaria, allergic dermatitis) and more severe (Quincke's edema, anaphylactic shock). Despite the fact that in our clinic allergy tests are carried out before prescribing medications, however, the occurrence of allergic reactions This may require additional drug treatment. Please, if you know about your personal intolerance to any medications, be sure to tell your doctor about it.

Thromboembolic complications.

Venous thrombosis and pulmonary embolism are life-threatening complications of any surgical procedure. That is why great attention is paid to the prevention of these complications. Depending on the degree of risk determined by your attending physician, preventive measures will be prescribed: bandaging lower limbs, administration of low molecular weight heparins.

Exacerbation of peptic ulcer of the stomach and duodenum.

Any, even minimally invasive, operation is stressful for the body and can provoke an exacerbation of gastric and duodenal ulcers. Therefore, in patients at risk of such a complication, prophylaxis with antiulcer drugs in the postoperative period is possible.

Despite the fact that any surgical intervention carries a certain risk of complications, refusing or delaying the operation also carries a risk of developing severe illness or complications. Despite the fact that the clinic’s doctors pay great attention to prevention possible complications, a significant role in this belongs to the patient. Performing cholecystectomy as planned, with non-advanced forms of the disease, carries a much lower risk of unwanted deviations from normal course surgery and postoperative period. Great importance The patient also has the responsibility for strict adherence to the regimen and recommendations of doctors.

Long-term rehabilitation after cholecystectomy.

Most patients after cholecystectomy are completely cured of the symptoms that bothered them and return to normal 1-6 months after surgery. ordinary life. If cholecystectomy is performed on time, before the occurrence of concomitant pathology from other organs of the digestive system, the patient can eat without restrictions (which does not negate the need for proper healthy eating), do not limit yourself in physical activity, do not take special medications.

If the patient has already developed concomitant pathology of the digestive system (gastritis, chronic pancreatitis, dyskinesia) he should be under the supervision of a gastroenterologist in order to correct this pathology. A gastroenterologist will give you recommendations on lifestyle, diet, dietary needs nutrition and, if necessary, drug treatment.