Monday, July 11, 2011

Are there any mistakes here (med notes)?

OPERATIVE PROCEDURE: Informed consent was obtained from the patient during her lucid intervals. She was taken to the operating room, placed upon the operating table were general anesthesia was obtained without difficulty. Patient had been previously intubated in the intensive care unit. The abdomen was preped and draped in sterile fashion. A right subcostal incision was fashioned. The abdomen was entered. The gallbladder was noted to be emphysematous and edematous. Gallbladder was removed by sharp dissection using a cautery. Cystic artery was dissected free, clamped and divided. It was ligated with 2-0 silk suture. The cystic duct similar dissected free clamp divided and tied to 2-0 silk suture. Common bile duct is noted to be dilated. A longitudinal incision was fashioned along the anterior portion of the common bile duct. Upon entering the bile duct purulent bile was drained. A 12-French T tube was then placed into the bile duct, and the bile duct was closed around the T tube using a 3-0 Vicryl suture. The T tube was then brought out a stab wound in straight fashion. A #10 Jackson-Pratt (JP) drain was placed in the Morison's pouch. Posterior fascia was closed with a 0 Vicryl running suture. The anterior fascia was closed with #1 PDS running suture. The skin was closed with staples. Drains were secured. The patient was taken to the intensive care unit intubated and in critical but stable condition.

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