Laparostomy in patients with acute diffused peritonitis

Authors

  • V. V. Benedykt I. Horbachevsky Ternopil National Medical University
  • A. M. Prodan I. Horbachevsky Ternopil National Medical University
  • V. M. Bahrii Ternopil Regional Clinical Hospital

DOI:

https://doi.org/10.11603/2414-4533.2022.2.13173

Keywords:

acute generalized peritonitis, laparostomy, improved method of laparostomy

Abstract

The aim of the work: to develop the criteria for the selection of surgical tactics for performing laparotomy in patients with acute genera­lized peritonitis (AGP) to improve the results of their surgical treatment.

Materials and Methods. A retrospective analysis of 50 medical records of inpatients who died of AGP was conducted. In clinical conditions, the results of treatment of 131 patients after surgical treatment of AGP were studied. The generally accepted set of studies included the determination of the Mannheim peritonitis index, the leukocyte intoxication index, the comorbidity index and the degree of operative and anesthetic risk according to the ASA scale. In addition, intra-abdominal pressure was measured according to I. Kron et al. (1984), M. Cheatham et al. (1998).

Results and Discussion. When conducting a retrospective analysis of medical records of deceased patients, it was established that intubation of the small intestine (SI) was performed only in 14.00 % of operated patients, and the end of the operation in the form of a laparostomy was performed in 10 (20.00 %) cases. As for patients whose treatment outcomes were studied in clinical settings, laparostomy was used in 18 (13.74 %) patients on AGP at the end of laparotomy. In 13 cases, this method was used during primary surgery, in 5 – during relaparotomy in patients with postoperative peritonitis. In 7 cases, we performed intubation of the SI by an open method with the help of an end enterostomy after a forced resection of the distal part of the organ and according to our proposed technique in case of inefficiency of closed antegrade decompression in patients with AGP during relaparotomy for unliquidated peritonitis. The use of the proposed method in patients made it possible to reduce the number of relaparotomies for closing the laparostomy with a favorable course of AGP, which significantly improved the results of surgical treatment of these patients.

References

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Published

2022-09-14

How to Cite

Benedykt, V. V., Prodan, A. M., & Bahrii, V. M. (2022). Laparostomy in patients with acute diffused peritonitis. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 42–45. https://doi.org/10.11603/2414-4533.2022.2.13173

Issue

No. 2 (2022)

Section

EXPERIENCE OF WORK

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