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Gallbladder Surgery: A Comprehensive Guide

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About Course

This course provides an in-depth exploration of gallbladder surgery, also known as cholecystectomy. It is designed for medical professionals, including surgeons, surgical residents, nurses, and medical students, who seek a comprehensive understanding of the procedures, techniques, and management strategies involved in gallbladder surgery. The course covers various aspects, from the initial patient assessment and diagnostic workup to surgical planning, operative techniques (both laparoscopic and open), and postoperative care. It also addresses potential complications and their management. Upon completion of this course, participants will be able to describe the indications for cholecystectomy, outline the steps involved in both laparoscopic and open techniques, identify potential complications and their management, and apply evidence-based principles to optimize patient outcomes. This course aims to enhance the knowledge and skills necessary to perform safe and effective gallbladder surgery, ultimately improving patient care and surgical outcomes. The course also explores emerging technologies and future directions in gallbladder surgery.

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What Will You Learn?

  • The participant will gain in-depth knowledge

Course Content

Surgical Techniques: Laparoscopic Cholecystectomy
This topic focuses on the laparoscopic approach to cholecystectomy, which has become the gold standard for gallbladder removal due to its minimally invasive nature, reduced post-operative pain, shorter hospital stay, and faster recovery. We will cover the essential steps of the procedure, including patient positioning, trocar placement, establishing pneumoperitoneum, dissection of the Calot's triangle, clipping and dividing the cystic duct and artery, gallbladder removal, and port closure. We will discuss various techniques for safe and effective dissection, such as the 'critical view of safety' for identifying the cystic duct and artery, and methods for managing inflammation or adhesions. Furthermore, we will address common challenges encountered during laparoscopic cholecystectomy, such as bleeding, bile spillage, and difficulty with visualization, and provide strategies for overcoming these challenges. The role of intraoperative cholangiography (IOC) in detecting and managing common bile duct stones will also be discussed. This topic aims to provide a comprehensive understanding of the laparoscopic cholecystectomy procedure, enabling surgeons to perform it safely and effectively, while minimizing the risk of complications.

  • Gallbladder Removal and Port Closure
  • Dissection of Calot’s Triangle
  • Clipping and Dividing the Cystic Duct and Artery
  • Patient Positioning and Trocar Placement
  • Gallbladder Removal and Port Closure – Quiz
  • Clipping and Dividing the Cystic Duct and Artery – Quiz
  • Dissection of Calot’s Triangle – Quiz
  • Patient Positioning and Trocar Placement – Quiz

Post-operative Management and Complications
This topic addresses the post-operative care and potential complications following gallbladder surgery. It covers immediate post-operative management, including pain control, wound care, and monitoring for complications. We will discuss common post-operative complications such as bleeding, infection, bile leakage, retained common bile duct stones, and post-cholecystectomy syndrome. The topic also covers strategies for managing these complications, including conservative measures, endoscopic interventions (such as ERCP), and surgical re-intervention. Furthermore, we will discuss the long-term outcomes following cholecystectomy, including the resolution of symptoms and the potential for post-cholecystectomy syndrome. This section also covers patient education and follow-up care to ensure optimal recovery and long-term well-being. The goal of this topic is to equip healthcare professionals with the knowledge and skills necessary to effectively manage patients in the post-operative period, recognize and treat complications promptly, and optimize long-term outcomes following gallbladder surgery.

Surgical Techniques: Open Cholecystectomy
This topic explores the open approach to cholecystectomy, which, although less common than laparoscopic cholecystectomy, remains a valuable surgical option in certain situations. Open cholecystectomy is typically indicated when laparoscopic surgery is contraindicated or technically difficult, such as in cases of severe inflammation, adhesions, or anatomical abnormalities. We will discuss the surgical technique, including the incision (typically a right subcostal incision), dissection to expose the gallbladder and biliary structures, ligation and division of the cystic duct and artery, gallbladder removal, and wound closure. We will also address techniques for managing common bile duct exploration in cases of suspected choledocholithiasis. This section also covers the management of potential complications, such as bleeding, bile duct injury, and wound infection. The goal of this topic is to provide a comprehensive understanding of the open cholecystectomy procedure, enabling surgeons to perform it safely and effectively when the laparoscopic approach is not feasible or appropriate.

Indications and Pre-operative Assessment
This topic covers the various indications for gallbladder surgery, focusing on symptomatic gallstone disease, acute cholecystitis, chronic cholecystitis, and other less common conditions such as gallbladder polyps and porcelain gallbladder. We will delve into the diagnostic workup, including a detailed history and physical examination, relevant laboratory investigations (such as liver function tests and complete blood count), and imaging modalities like ultrasound, CT scans, and HIDA scans. The pre-operative assessment also includes evaluating the patient's overall health status, identifying any co-morbidities that may increase surgical risk (e.g., cardiovascular disease, diabetes, coagulopathies), and optimizing their medical condition before surgery. Furthermore, we will discuss the importance of patient education and informed consent, ensuring that patients understand the risks, benefits, and alternatives to surgery. This section also covers the role of antibiotics, anticoagulation management, and bowel preparation in the pre-operative period. The goal of this topic is to equip healthcare professionals with the knowledge and skills necessary to appropriately select patients for gallbladder surgery and to prepare them for a safe and successful surgical outcome.

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