IMPROVING THE RESULTS OF THE LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH COMPLICATED COURSE OF THE CALCULOUS CHOLECYSTITIS
| Autor: | Yaroslav V Karyi, Yevhen V Shaprynskyi, Yura V Babiichuk, Oleg Y Kanikovskyi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Bile duct business.industry Group ii Gold standard General Medicine medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis medicine Acute cholecystitis Cholecystitis 030211 gastroenterology & hepatology In patient business Surgical treatment Laparoscopic cholecystectomy |
| Zdroj: | Wiadomości Lekarskie. 72:790-794 |
| ISSN: | 0043-5147 |
| DOI: | 10.36740/wlek201905113 |
| Popis: | OBJECTIVE Introduction: The laparoscopic cholecystectomy (LCE) has become "gold standard" in treatment of the gallstone disease (GSD). However, introduction of LCE is accompanied by increase in the frequency of the bile duct injuries by 2-5 times, and transfer to the conversion offsets main advantages of the laparoscopic access. The aim:Тo improve the results of treatment of the patients with complicated course of the calculous cholecystitis by developing new methods of the laparoscopic cholecystectomy. PATIENTS AND METHODS Materials and methods: The results of surgical treatment of 420 patients with complicated course of the calculous cholecystitis were analyzed. The patients were divided intwo groups: group I (n = 210) where the standard four-trocar LCE was used and the group II (n = 210) where the developed methods of LCE were used. The average age made up 62 ± 6.0 years. Duration of disease made up from 1 month to 35 years. RESULTS Results: The patients in group I LCE with complicated course of the acute cholecystitis was performed in 108 (25.7%) cases, chronic - in 102 (24.3%) cases. The patients in group II surgical intervention with complicated course of the acute cholecystitis was performed in 112 (26.7%) cases, chronic - in 98 (23.3%) cases. The patients of group I intraoperative injuries were observed in 12 (5.7%) cases and patients of group II - in 4 (1.9%) cases. The conversion was applied in 13 (6.2%) and in 4 (1.9%) cases, respectively. 2 (0.9%) patients died. CONCLUSION Conclusions: Introduction of the developed methods of LCE with complicated course of the calculous cholecystitis allows to reduce the frequency of intraoperative injuries by 3,8% and conversion rate - by 4,3% (p |
| Databáze: | OpenAIRE |
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