RESULTS OF PREDICTING VENOUS THROMBOSIS AND EMBOLISM IN THE TREATMENT OF ACUTE CALCULOUS CHOLECYSTITIS

Authors

DOI:

https://doi.org/10.11603/2414-4533.2024.2.14843

Keywords:

acute calculous cholecystitis, complications, venous thrombosis and embolism, deep vein thrombosis, pulmonary embolism, risk assessment method

Abstract

The aim of the work: to improve the results of treatment of patients with acute calculous cholecystitis and its complications through differentiated prevention of venous thrombosis and embolism by the use of a developed prognostic model for determining the degree of their risk.

Materials and Methods. In the course of the study, the results of the examination and treatment of 101 patients with acute calculous cholecystitis and its complications for the period from 2021 to 2022 were analyzed on the basis of the Department of Surgery, Plastic Surgery and Endoscopy of the FPDO of Danylo Halytsky Lviv National Medical University (KNP 1 TMO, Lviv, Department of Surgery and Oncology №2). The majority were women (69 patients, or 68.3 %) aged 24 to 86 years (average age 59.0 ± 15.29 years). The patients were grouped according to the occurrence of the disease complications (34 patients, or 33.7 %) or their absence. The nature of the complications were mostly related to the combination of acute calculous cholecystitis with ductal pathology. The entire sample of patients was subject to clinical, laboratory and instrumental analysis. As a result of the examinations and analyzing of the data, 3 cases (21.4 %) of thrombosis in the veins of the lower legs and sural sinuses were detected, 2 cases (14.3 %) – thrombosis of the popliteal vein, 2 cases (14.3 %) – thrombosis of the superficial femoral vein, 2 cases (14 .3 %) – thrombosis of common femoral,  and 3 cases (21.4 %) – of the iliac veins.

Results and Discussion. In the course of the research and statistical analysis, 9 factors were singled out that have a reliable influence on the occurrence of venous thrombosis and embolism: interleukins 1β and 4, TNF, prothrombin index, total fibrinogen, INR, D-dimers, values ​​of the Caprini and Rogers scales. Formulas were developed for calculating the value for determining the probability of developing thrombotic complications with acute uncomplicated and complicated calculous cholecystitis, respectively. The implementation in the clinic of developed objective prognostic models for determining the risk of venous thrombosis and embolism, respectively, the use of a preventive method in patients with acute calculous cholecystitis and its complications made it possible to significantly reduce the frequency of these complications in general from 32.7 % to 11.5 %, in uncomplicated cases from 12.1 % to 5.1 % and in complicated cases – from 43.8 % to 15.4 % (р < 0.05).

References

Verkholaz IL, Yaroshenko EA, Malinovsky SL. Venous thromboembolism in surgical practice. Med. perspekt 2018; 23(4(part1):46-50. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/145660

Liesnyi VV, Filonenko VO, Liesna AS. Prevention of thromboembolic complications of surgical patients. Kharkiv Surgical School 2021; (3): 35-37. Available from: https://doi.org/10.37699/2308-7005.3.2021.07

Hvalyboga DV. Trombozy systemy nyzhnʹoyi porozhnystoyi veny v planoviy ta urhentniy khirurhiyi–poperedzhennya rozvytku tromboemboliyi lehenevoyi arteriyi. dys. kand. med. nauk [Thrombosis of the inferior vena cava system in planned and urgent surgery – prevention of the development of pulmonary embolism. Dissertation for candidate of medical science]. Ternopil; 2022. In Ukrainian. Available from: https://repository.tdmu.edu.ua//handle/123456789/17471.

Ashcroft K, Theocharidou L. VTE Prophylaxis Post-Laparoscopic Cholecystectomy. British Journal of Surgery 2022; 109:123. Available from” https://doi.org/10.1093/bjs/znac039.123.

Balachandran R, Jensen KK, Burcharth J Ekeloef S, Schack AE, Gögenur I. Incidence of Venous Thromboembolism Following Major Emergency Abdominal Surgery. World J Surg 2020; (44):704–10. Available from: https://doi.org/10.1007/s00268-019-05246-x.

Chen CH, Lin CL, Kao CH. The risk of venous thromboembolism in patients with gallstones. Int J Environ Res Public Health 2020; Available from: https://doi.org/10.3390/ijerph17082930.

Nicholson M. Prevention of venous thromboembolism in 2020 and beyond. Journal of clinical medicine 2020; (9.8):2467. Available from: https://doi.org/10.3390/jcm9082467.

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Published

2024-06-28

How to Cite

KOROL, Y. A., KAVKA, M. P., & FEDCHYSHYN, N. P. (2024). RESULTS OF PREDICTING VENOUS THROMBOSIS AND EMBOLISM IN THE TREATMENT OF ACUTE CALCULOUS CHOLECYSTITIS. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 27–31. https://doi.org/10.11603/2414-4533.2024.2.14843

Issue

No. 2 (2024)

Section

ORIGINAL INVESTIGATIONS

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Copyright (c) 2024 Я. А. КОРОЛЬ, М. Р. КАВКА, Н. Р. ФЕДЧИШИН

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