Successful surgery of a giant gallbladder with multiple stones accompanied by symptoms of acute cholecystitis and nursing care: a case report

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Introduction: Acute cholecystitis is a common surgical condition and the most frequent cause of right upper quadrant (RUQ) abdominal pain, accounting for 3–10% of all abdominal pain cases. This case report describes the successful surgical management of a giant gallbladder with multiple stones, presenting with symptoms of acute cholecystitis, along with the associated nursing care. Case presentation: A 42-year-old man with a history of methadone and alcohol use presented with RUQ abdominal pain. The diagnosis was confirmed via ultrasound, laboratory tests, clinical history, and physical examination by a general surgeon and radiologist. Upon admission, the patient’s visual analog scale (VAS) pain score was 7 out of 10, which decreased to 5 preoperatively and to 2 postoperatively. Vital signs remained normal throughout the hospitalization. Due to the unavailability of laparoscopic equipment, an open cholecystectomy was performed via a Kocher incision. Intraoperatively, a giant gallbladder measuring approximately 20 cm × 8 cm was identified. A chevron incision was subsequently made along the Kocher line. The surgery was completed successfully. Discussion and conclusion: Accurate diagnosis and timely surgical intervention are critical in gallbladder pathology, and structured postoperative nursing care is highly recommended.