Open Cholecystectomy Periprocedural Care

Updated: Feb 15, 2017
  • Author: William W Hope, MD; Chief Editor: Kurt E Roberts, MD  more...
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Periprocedural Care

Equipment

Equipment for open cholecystectomy includes instruments common to a major instrument tray, as follows:

  • Kelly clamps, Kocher forceps, needle holders, scissors, clips, suctions, knife/knife handles, forceps, retractors, right angle clamps, Kitner dissectors, and electrosurgical devices should be assembled
  • Balfour retractors, Bookwalter retractors, or other self-retaining retractors can be used, according to the surgeon's preference
  • Sutures or clips can be used to control the cystic duct and artery, depending on the surgeon's preference and the size of the structures (see Technique); long instruments may be needed, depending on the body habitus of the patient

A headlight worn by the operating surgeon or assistant is often valuable in open cholecystectomy for improving visualization.

Several types of cholangiography catheters are available if cholangiography is to be performed.

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Patient Preparation

Anesthesia

Most open cholecystectomies are performed with general anesthesia. Less commonly, the procedure is done with regional (epidural or spinal) anesthesia; in rare instances, it is done with local anesthesia.

Positioning

Patients are positioned supine with the arms extended. Placing a folded blanket or bump underneath the patient's right back or inverting the table may be beneficial.

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