Pharmacologic therapeutic management

Nutrition:
Normal Saline Solution (1000 mL at 30 gtts/min)

Pain Reliever:
Demerol (25-50 mg IV q 6 – 8 hours)
Tramadol (IM/IV: 50-100 mg q6)
Antibiotics:
Ceftriaxone (1-2 grams/day IV)

Gallstone Dissolution:
Ursodeocycholic Acid (10-15 mg/kg per day)

Monitoring and follow-up care: (altered)

• Inform the patient of possible bile duct stone recurrence.
• Evaluate for symptomatic signs of gallstone disease.
• Follow patients on oral dissolution agents with serial liver enzymes, serum cholesterol and
imaging
• A low-calorie diet such as a plant based diet is preferred.
• In Laparoscopic gallbladder removal, most patients can be discharged on the same day.
• The pain is minimal and can be managed by over the counter pain relievers. Shoulder pains
may persist due retained CO2 during surgery so inform patient that the pain will subside in a few
days.
• Inform patient of possible temporary intolerance to fatty foods due to loss of stored bile in the
gallbladder but in time the liver will compensate and patient will see improvements of this symptom.
• 3-4 weeks follow up schedule after operation. Check patient’s sutures for redness, or any
signs of possible infection

• After surgery, to prevent further complications bed rest and maintenance of electrolyte
balance is advised.