Nursing care for cholecystectomy with underlying disease : 2 case study
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Abstract
Objective: To compare nursing care outcomes in patients with gallstone disease undergoing open cholecystectomy who had underlying comorbidities.
Methods: This study employed a comparative case study design involving two patients with gallstone disease and comorbid conditions. Data were obtained from inpatient medical records and analyzed using Gordon’s 11 Functional Health Patterns framework. The analysis focused on pathophysiology, clinical manifestations, surgical treatment, nursing problems, and nursing diagnoses across the preoperative, postoperative, and continuing care phases, including discharge planning. The study was conducted between November 15, 2025 and January 15, 2026.
Results: Case 1 A 66-year-old Thai female with diabetes mellitus, hypertension, and stage 3 chronic kidney disease. She presented with abdominal pain and nausea for one day before admission and was diagnosed with acute cholecystitis. The patient underwent open cholecystectomy with a hospital stay of 13 days.
Case 2 A 83-year-old Thai male with hypertension and ischemic heart disease. He presented with abdominal pain, dyspnea, and fatigue for one hour before admission and was diagnosed with acute cholecystitis. The patient underwent open cholecystectomy with a hospital stay of 16 days.
Conclusion: The nursing care outcomes achieved the planned goals in terms of patient safety, postoperative recovery, complication prevention, and discharge readiness. The findings highlight the importance of holistic nursing care and the critical role of nurses in managing complex surgical patients with comorbidities, particularly among older adults.
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References
Lammert F, Gurusamy K, Ko CW, Miquel JF, Mendez-Sanchez N, Portincasa P, et al. Gallstones. Nat Rev Dis Primers 2. 2016; 16024 https://doi.org/10.1038/nrdp.2016.24
Pisano M, Allievi N, Gurusamy K, Borzellino G, Cimbanassi S, Boerna D, et al. 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. World Journal of Emergency Surgery,2020; 15:61. https://doi.org/10.1186/s13017-020-00336-x
Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: Cholelithiasis and cancer. Gut and Liver 2012;6(2), 172–187. https://doi.org/10.5009/gnl.2012.6.2.172
Panpimanmas S, Manmee C. Risk factors for gallstone disease in a Thai population. Journal of Epidemiology 2009;19(3):116–121. https://doi.org/10.2188/jea.je20080019
Ko-Iam W, Sandhu T, Paiboonworachat S, Pongchairerks P, Chotorosniramit A, Chotorosniramit N, et al. Predictive factors for a long hospital stay in patients undergoing laparoscopic cholecystectomy. International Journal of Hepatology 2017; 5497936. https://doi.org/10.1155/2017/5497936
โรงพยาบาลมุกดาหาร. สถิติผู้ป่วยผ่าตัดนิ่วในถุงดีที่มีโรคร่วม ปี 2566–2568. มุกดาหาร: โรงพยาบาลมุกดาหาร; 2568.
Gordon M. Manual of nursing diagnosis. 13th ed. Burlington: Jones & Bartlett Learning; 2014
สุปราณี เสนาดิสัย. กระบวนการพยาบาลและการนำไปใช้. กรุงเทพฯ: สำนักพิมพ์จุฬาลงกรณ์ มหาวิทยาลัย; 2561
อรรถสิทธิ์ ศรีสุบัติ และคณะ. การประเมินทางเศรษฐศาสตร์การผ่าตัดผ่านกล้องเปรียบเทียบกับการผ่าตัดแบบเปิดในการรักษานิ่วในถุงน้ำดี [อินเทอเน็ต]; 2563 [เข้าถึงเมื่อ 20 สิงหาคม 2568]. เข้าถึงได้จาก: https://www.dms.go.th/backend//Content/Content_File/Research/Attach/25640705131439PM_%E0%B8%A3%E0%B8%B2%E0%B8%A2%E0%B8%87%E0%B8%B2%E0%B8%99%20MIS%2020210119.pdf
Camilleri M. Bile acid diarrhea: Prevalence, pathogenesis, and therapy. Gut and Liver 2015; 9(3):332–339. https://doi.org/10.5009/gnl1439
Lazarus R S, Folkman S. Stress, appraisal, and coping. New York; Springer; 1984
Hinkle JL, Cheever KH. (2018). Brunner & Suddarth’s textbook of medical-surgical nursing. 14th ed. Pennsylvania: Wolters Kluwer; 2018
จิราพร ค้าแก้ว, สิริพรรณ พัฒนาฤดี, ณัฏฐดา อารีเปี่ยม. การจัดการความปวดของผู้ใหญ่หลังผ่าตัดช่องท้องแผนกศัลยกรรมทั่วไป โรงพยาบาลนพรัตน์ราชธานี. ธรรมศาสตร์เวชสาร 2558;15(1):80-91.
Donabedian A. The quality of care: How can it be assessed? JAMA 1988;260(12):1743–1748. https://doi.org/10.1001/jama.260.12.1743
Ljungqvist O, Scott M, Fearon KCH. (). Enhanced recovery after surgery: A review. JAMA Surgery 2017;152(3):292–298. https://doi.org/10.1001/jamasurg.2017.091
Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surgery 2017;152(8):784–791. doi: 10.1001/jamasurg.2017.0904.
Naylor MD, Aiken LH, Kurtzman ET, Olds DM, Hirschman KB. The importance of transitional care in achieving health reform. Health Affairs 2011;30(4):746–754. https://doi.org/10.1377/hlthaff.2011.0041
Orem DE. Nursing: Concepts of practice. 6th ed. St. Louis: Mosby; 2001
