Postoperative Care

Oral fluids are started on the day of surgery. Nasogastric tubes are unnecessary for most patients. If a Jackson-Pratt drain has been inserted at surgery, it is removed the next morning. Oral analgesics are provided to help patients tolerate the postoperative pain. However, during the first 12 hours, some patients require parenteral analgesia. The postoperative course is similar to that for laparoscopic cholecystectomy, except that some endocrine disorders necessitate hormonal support and additional clinical laboratory data. Unexplained hypotension, fever, and confusion may be due to acute adrenocortical insufficiency. These patients should have blood drawn to determine Cortisol levels and be immediately treated with 100 mg of hydrocortisone intravenously. Most patients are ambulatory by the evening of the procedure, and most are allowed to leave by the third postoperative day. However, discharge may be delayed in patients who require substantial hormonal support or adjustments of antihypertensive medications.

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