ANALYSIS OF PERSONAL RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH ACUTE CALCULOUS CHOLECYSTITIS USING LAPAROSCOPIC CHOLECYSTECTOMY
DOI:
https://doi.org/10.11603/2414-4533.2025.2.15270Keywords:
laparoscopic cholecystectomy, diagnosis, treatmentAbstract
The aim of the work: to analyze the personal experience of treatment of acute calculous cholecystitis using laparoscopic cholecystectomy.
Materials and Мethods. A retrospective analysis of the treatment of 685 patients with uncomplicated acute calculous cholecystitis, who were hospitalized during 2021–2024, was conducted. Ultrasound examination of the abdominal organs were performed on Alpinion E-CUBE I7 and Esaote mylab seven devices. All laparoscopic cholecystectomies were performed under general anesthesia using the Karl Storz IMAGE 1 instrumentation and equipment. The effectiveness of treatment was assessed by the duration of hospital stay before and after surgery, the duration of surgery, the frequency of conversions, and intraoperative complications, as well as by complications of the postoperative period and postoperative mortality of patients. Statistical processing was performed using the SPSS 20.0 for Windows statistical software package.
Results. During the examination, the most characteristic diagnostic symptoms of acute calculous cholecystitis were: constant or paroxysmal pain in the right subcostal area in 100 % of patients; Murphy’s sign in 92.5 % of cases; increased C-reactive protein – 62.5 % of patients; increase the number of leukocyte – 97.8 % of patients. During a comprehensive examination, 87.4 % of patients were found to have a number of concomitant pathologies. The main method of visualization of the acute calculous cholecystitis was ultrasound, which was performed in 100 % of patients. The majority of surgical interventions were performed within 76 hours from the moment of admission to the hospital (78.8 %, р<0.001). The most frequent complications of acute calculous cholecystitis were: empyema of the gallbladder – 22.7 %, hydrops of the gallbladder – 12.5 %, local peritonitis – 13.8 %, paravesical abscess – 6.5 %, perforation of the gallbladder – 0.8 %.
Conclusions. A timely clinical examination was conducted that fully allowed us for the diagnosis of acute calculous cholecystitis and, as soon as possible, to determine indications for surgical treatment. Therefore, early laparoscopic cholecystectomy allows to reduce the traumatic nature of surgical intervention, the number of intra- and postoperative complications, and significantly reduce the duration of inpatient treatment and rehabilitation of patients.
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