Classification of the therapy
- Conservative
- Operational
- ERCP
- Demolition
- Nutrition
1. conservative therapy
The therapy of an acute inflammation of the gall bladder can be done in different ways. With conservative therapy, in addition to bed rest, absolute food restrictions must be observed. In case of nausea and vomiting, a stomach tube may be useful.
Nutrition is parenteral, i.e. through infusions with sufficient volume and electrolyte replacement. The severe pain of the inflammation of the gall bladder is treated with painkillers. Care must be taken to ensure that no drugs containing morphine are used, as they lead to an increase in muscle tone at the sphincters, which increases the pain symptoms. Medication against nausea and antispasmodic drugs (spasmolytics) are also indicated, as are antibiotics.
2. operative therapy of the inflammation of the gall bladder
However, if the cause of the acute inflammation is a gallstone disease or a stuck stone, a cholecystectomy is recommended if there are no contraindications for surgery. This means surgical removal of the gallbladder including gallstones. In most cases, open surgery is not necessary.
Nowadays, modern surgical procedures offer a less risky and gentler method, in which the gallbladder is usually removed minimally invasively through four approximately 2 cm long skin incisions in the abdomen (laparoscopy). The postoperative recovery time is shorter and fewer complications occur. In the case of post-operative procedures without complications, the patient can usually leave the hospital on the 3rd day after surgery after checking all relevant parameters. Wound control, changing of dressings and removal of stitches is then carried out by the family doctor. If the operating physician has to decide in favor of an open abdominal incision, the length of stay and risk of complications are higher with this therapy for gall bladder inflammation.
3RD ERCP
Another possibility for the therapy of gallbladder inflammation is the ERCP described above, whereby stones are removed through a tube inserted through the mouth. Extracorporeal shock waves break up stones. The fragments then enter the intestine via the bile ducts and are excreted with the stool.
In the first days after the operation, one should limit oneself to a light diet. The gallbladder is a hollow organ that stores the bile produced by the liver, thickening it and releasing it into the small intestine as needed (i.e. especially after meals). In the small intestine, the bile serves to emulsify dietary fats, which can only be absorbed in this way.
It is therefore important for fat digestion. By surgically removing the gallbladder, the bile reaches the small intestine directly, so the storage function is eliminated. With larger fatty meals, it is not always possible to provide a sufficient amount of juice and digestive problems occur. Therefore, larger fatty meals should be avoided.