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    Physiotherapy in Gastrectomy Cholecystectomy

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    akheel ahammed
    This document discusses various abdominal surgeries and the role of physiotherapy in postoperative care. It covers common operations like gastrectomy, cholecystectomy, appendectomy and their causes, procedures, complications and physiotherapy management. For gastrectomy, it details partial and total removal of the stomach for ulcers or cancer. Post-op care includes nasogastric tube, IV fluids, antibiotics and gradual advancement to solid foods. Physiotherapy focuses on chest PT, early mobilization and treating issues like reduced cough reflex or fatigue. For cholecystectomy, it outlines laparoscopic removal of the gallbladder for conditions like cholecystitis and physiotherapy to address increased mucus in the right lung.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Physiotherapy in Gastrectomy Cholecystectomy

    Uploaded by

    akheel ahammed
    2K views19 pages
    This document discusses various abdominal surgeries and the role of physiotherapy in postoperative care. It covers common operations like gastrectomy, cholecystectomy, appendectomy and their causes, procedures, complications and physiotherapy management. For gastrectomy, it details partial and total removal of the stomach for ulcers or cancer. Post-op care includes nasogastric tube, IV fluids, antibiotics and gradual advancement to solid foods. Physiotherapy focuses on chest PT, early mobilization and treating issues like reduced cough reflex or fatigue. For cholecystectomy, it outlines laparoscopic removal of the gallbladder for conditions like cholecystitis and physiotherapy to address increased mucus in the right lung.

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    pt in gastrectomy cholecystectomy

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    Physiotherapy in gastrectomy cholecystectomy

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    This document discusses various abdominal surgeries and the role of physiotherapy in postoperative care. It covers common operations like gastrectomy, cholecystectomy, appendectomy and their causes, procedures, complications and physiotherapy management. For gastrectomy, it details partial and total removal of the stomach for ulcers or cancer. Post-op care includes nasogastric tube, IV fluids, antibiotics and gradual advancement to solid foods. Physiotherapy focuses on chest PT, early mobilization and treating issues like reduced cough reflex or fatigue. For cholecystectomy, it outlines laparoscopic removal of the gallbladder for conditions like cholecystitis and physiotherapy to address increased mucus in the right lung.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    2K views19 pages

    Physiotherapy in Gastrectomy Cholecystectomy

    Uploaded by

    akheel ahammed
    This document discusses various abdominal surgeries and the role of physiotherapy in postoperative care. It covers common operations like gastrectomy, cholecystectomy, appendectomy and their causes, procedures, complications and physiotherapy management. For gastrectomy, it details partial and total removal of the stomach for ulcers or cancer. Post-op care includes nasogastric tube, IV fluids, antibiotics and gradual advancement to solid foods. Physiotherapy focuses on chest PT, early mobilization and treating issues like reduced cough reflex or fatigue. For cholecystectomy, it outlines laparoscopic removal of the gallbladder for conditions like cholecystitis and physiotherapy to address increased mucus in the right lung.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 19

    Physiotherapy in

    abdominal surgery
    A.THANGAMANI RAMALINGAM
    PT, MSc(PSY),MIAP

    Common
    operations

    Gastrectomy
    Cholecystectomy
    Appendecectomy
    Colectomy
    Colostomy
    Ileostomy
    Herniotmy/ Herniorrhaphy/plasty
    Nephrectomy
    Prostatectomy
    Cystectomy
    Mastectomy
    Hysterectomy

    Gastrectomy
    Removal

    of all or part of the stomach


    gastrectomy was mostly used as a
    treatment for stomach/duodinal
    ulcers, however now this procedure
    is used primarily for cancer of the
    stomach
    Partial /total gastrectomy

    Causes
    Peptic

    ulcer( gastric/duodenal)
    Pyloric stenosis
    Zollinger-ellison syndrome
    (hypergastrinaemia)
    Malignancy (gastrinoma)

    Operations

    Vagotomy
    Pyloroplasty
    Gastrojeunostomy
    Antrectomy (1/3 of stomach excised)
    Partial gastrectomy(2/3 of distal stomach excised)
    Total gastrectomy
    Billroth I gastro-duodenal anastomosis-gastric
    ulcer
    Polya operation-gastro-jejunal anastomosisduodenal ulcer
    Sleeve gastrectomy
    5

    Nasogastric

    tube in situ (two hourly

    suction)
    3rd day liquid diet
    5th or 6th day normal diet

    complications
    Resp/circulatory/electrolyte

    imbalance
    early complications (with in a year)
    paralytic ileus, stomal obstruction,
    duodenal blow out, post dumping
    syndromes, pancreatitis, vomiting
    Late complications
    recurrent ulcer, fistula, nutritional
    deficiency, intestinal
    obstruction,TB,gallstones
    9

    Post-operative care
    Depending on the severity of the
    surgery, the patient may be sent to a
    regular surgical room or may be sent to
    the surgical intensive care unit to be
    more closely monitored
    The nasogastric tube is left in place and
    connected to suction to keep the
    stomach empty. The tube is removed
    when stomach and bowel function
    returns to normal, usually in 2 - 3 days
    10

    Fluids are given by vein (intravenously, I.V.)

    Antibiotics are usually given I.V. for 24 hours

    Oxygen may be given by nasal catheter

    Gradually the diet is increased from liquids to soft food and


    then more solid foods. A special diet may be necessary for many
    of the patients with a gastrectomy

    The wound is kept clean to prevent infection. Lotions should


    not be applied to the wound

    If radiation therapy or chemotherapy is given, there will be


    follow up with a radiologist or oncologist.

    Blood tests, CT scans and other diagnostic tests may be


    necessary to follow the course of the disease

    11

    Physiotherapy

    Common pre-op training


    Post op assessment
    Problems
    1.increased production of mucus
    secretions of lower lobe of left lung
    2.inhibited cough reflex due to pain &
    ryles tube
    3.tiredeness-anaemia-less RBC production
    4.haemetemesis
    12

    Treatment

    Chest pt
    Encourage cough reflex
    Treat for short duration
    Arm/leg exs
    Early mobilization-prop up in the evening or next
    day
    Wound care
    Micturition /bowel
    Pain relief
    Oral hygiene
    Diet
    13

    Cholecystectomy
    the

    operation for removal of the gall


    bladder

    Laparoscopic

    Cholecystectomy

    ERCP

    (Endoscopic Retrograde
    Cholangio-Pancreatography
    14

    Causes
    Acute/chronic

    cholecystitis

    Cholelithiasis
    Volvulus

    cholesterosis
    carcinoma

    15

    Operations
    Mini

    cholecystectomy
    Cholecystostomy
    Extended with hepatic lobectomy
    cholecystolithotomy

    16

    Kochers

    incision
    Right upper paramedian incision
    T TUBE/cigarette drain/under water
    seal drain/corrugated rubber sheet
    Duct-first/fundus first method

    17

    Complications
    Damage

    to bile duct/right hepatic


    artery/cystic artery
    Waltman-walters syndrome
    bile leakage,chest/abs pain
    mimics pulmonary embolism/highly
    fatal

    18

    Physiotherapy
    Problems

    1.increased production of mucus


    secretions of lower lobe of right lung
    PT as per protocol

    19

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