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Grand Case NP 5 Laparoscopic Cholecystectomy
Grand Case NP 5 Laparoscopic Cholecystectomy
CLIENT BASED
NON-MODIFIABLE FACTORS
*Age Increase in age = increase in prevalence of
gallstones (bile becomes more lithogenic)
Biliary sludge
Increased
estrogen( Stimulates Made up of hydrophobic
hepatic cholesterol regions that can bind to
secretion into bile) cholesterol, phospholipid and
bilirubin
Gallbladder volume is
doubled(bile stasis)
Acidifies bile
Precursor of
prostaglandin
Increase solubility of Stimulates mucin secretion
calcium salts
Biliary sludge
Precipitation
less favorable
Made up of hydrophobic
regions that can bind to
cholesterol, phospholipid and
bilirubin
STONE
CHOLESTEROL STONE-undissolved
cholesterol
Damage of gallbladder
mucosa (mucosal trauma)
Chronic obstruction
Converts lecithin to lysotecithin Inflamed gallbladder nocireceptors which are located in the
liver, GI tract responds to noxious stimuli
somatosensory cortex
Chemoreceptor trigger zone (CTZ)
Vomiting
center located
in the medulla
Rapid and
forceful
evacuation of
stomach
contents
JAUNDICE NAUSEA AND
PAIN
VOMITING
(vomiting reflex)