Monitor patient's vital signs initially post procedure
13
Transport patient to recovery room
14
Monitor patient during recovery period
15
Approval: Surgeon for initial recovery results
16
Educate the patient about the care and management of the tube at home
17
Schedule follow-up appointments
18
Document the procedure and outcome in patient’s record
Ensure patient's informed consent
Before proceeding with the cholecystostomy tube placement procedure, ensure that the patient has given their informed consent. describe procedure, its potential benefits, risks, and possible complications. Answer any questions or concerns the patient may have, and obtain their signature on the consent form.
Prepare surgical area and the patient
Prepare the patient for the cholecystostomy tube placement procedure by ensuring they are in a comfortable position on the operating table. Disinfect the surgical site using an antiseptic solution, making sure to cover a wide area around the gallbladder. Cover the patient with sterile drapes, leaving only the surgical site exposed.
Administer anesthesia
Administer anesthesia to the patient to ensure their comfort and to minimize pain during the procedure. Administer the anesthesia according to the patient's medical history and any allergies they may have. Verify the patient's vital signs regularly throughout the administration of anesthesia.
1
General anesthesia
2
Local anesthesia
3
Regional anesthesia
Use ultrasound for locating gallbladder
Use ultrasound imaging to locate the gallbladder. Apply a gel to the patient's abdomen and use the ultrasound probe to identify the gallbladder's position. Adjust the probe as needed to obtain a clear image and confirm the location of the gallbladder.
Make incision necessary for the procedure
Make an incision in the patient's abdomen to gain access to the gallbladder. Use a scalpel to make a small, precise incision, taking care not to damage any surrounding structures. Control bleeding using sterile gauze or sutures as needed.
Insert needle into the gallbladder
Insert a needle into the gallbladder through the incision. Use ultrasound guidance to ensure accurate placement. Advance the needle slowly, taking care not to puncture any nearby organs or structures. Verify needle placement using aspiration of fluid or contrast material.
Drain the fluid inside the gallbladder
Drain the fluid inside the gallbladder using a syringe or vacuum system. Apply gentle pressure as needed to facilitate drainage. Collect the fluid in a sterile container for further analysis, if necessary.
Insert cholecystostomy tube
Insert a cholecystostomy tube into the incision made in the gallbladder. Select an appropriate size and type of tube based on the patient's anatomy and the clinical indication for the procedure. Ensure proper positioning of the tube within the gallbladder before securing it in place.
1
12 Fr
2
14 Fr
3
16 Fr
Secure the tube and close the incision
Secure the cholecystostomy tube in place using sutures or a securement device. Close the incision made in the abdomen using sterile sutures or adhesive strips. Apply an appropriate dressing to protect the incision site.
Verify correct placement of tube via imaging
Verify the correct placement of the cholecystostomy tube using imaging techniques such as X-ray or ultrasound. Confirm that the tube is positioned within the gallbladder and that there are no signs of leakage or displacement.
1
X-ray
2
Ultrasound
Clean and dress the surgical area
Clean and dress the surgical area to ensure proper hygiene and reduce the risk of infection. Use sterile saline or antiseptic solution to clean the surrounding skin. Apply sterile dressings and cover the incision site with a transparent dressing for easy monitoring.
1
Gauze dressing
2
Transparent dressing
3
Foam dressing
Monitor patient's vital signs initially post procedure
Monitor the patient's vital signs closely immediately after the cholecystostomy tube placement procedure. Keep track of their blood pressure, heart rate, oxygen saturation, and respiratory rate. Document any abnormal readings or trends and report them immediately.
1
Blood pressure
2
Heart rate
3
Oxygen saturation
4
Respiratory rate
Transport patient to recovery room
Transport the patient to the recovery room after the cholecystostomy tube placement procedure. Ensure the patient is stable, comfortable, and properly positioned during transportation. Facilitate communication between the surgical team and the recovery room staff to provide continuity of care.
Monitor patient during recovery period
Monitor the patient closely during the recovery period to identify any signs of complications or adverse reactions. Assess the patient's pain level, vital signs, and overall well-being at regular intervals. Provide appropriate interventions or medications as needed and document the patient's response to treatment.
1
Fever
2
Bleeding
3
Pain
4
Infection
5
Nausea
Approval: Surgeon for initial recovery results
Will be submitted for approval:
Monitor patient during recovery period
Will be submitted
Educate the patient about the care and management of the tube at home
Educate the patient about how to care for and manage the cholecystostomy tube once they are discharged from the hospital. Provide written instructions and demonstrate any necessary techniques, such as how to clean the tube site, change dressings, and troubleshoot common problems. Answer any questions the patient may have.
Schedule follow-up appointments
Schedule follow-up appointments for the patient to monitor the cholecystostomy tube and assess their overall condition. Provide the patient with appointment details, including date, time, and location. Coordinate with the appropriate healthcare providers to ensure seamless continuity of care.
Document the procedure and outcome in patient’s record
Thoroughly document the details of the cholecystostomy tube placement procedure and its outcome in the patient's medical record. Include relevant information such as the patient's condition before and after the procedure, any complications encountered, and the patient's response to treatment. Ensure accuracy and completeness of the documentation.
