Diagnostic criteria for prediction of possible complications in patients with chronic calculous cholecystitis and concomitant pathology of lower ex¬tremitiy veins
DOI:
https://doi.org/10.11603/2414-4533.2017.4.8384Keywords:
cholecystitis, varicose veins, simultaneous interventions, clinical and instrumental methods of research, duplex scanning of veins.Abstract
The aim of the work: to study the state of homeostasis of the body during and after the implementation of minimally invasive surgical interventions, which will allow the development of a pathogenetically substantiated correction of possible disorders.
Materials and Methods. Patients with chronic calculous cholecystitis and pathology of the veins of the lower extremities in the pre-operative period were subjected to a complex of diagnostic instrumental-laboratory methods of examination that included laboratory studies with biochemical blood analysis, sonography of the pancreatohepatobiliary zone, retroperitoneal space and fibrogastroduodenoscopy. For an objective assessment of the state of homeostasis, the indices of each individual patient were evaluated, and then the total result was determined.
Results and Discussion. It is established that the cholecystitis clinic is accompanied by a pronounced polymorphism, and the generally accepted indicators of the inflammatory process do not coincide with the registered pathological changes. Based on the results of the study, the expediency of corrective drug therapy in patients after laparoscopic cholecystectomy for more than 90 minutes is justified in the postoperative period. In 26 patients among the 130 diagnosed with concomitant pathology – varicose veins of the lower extremities. We noted that in patients admitted to the hospital with a diagnosis of chronic calculous cholecystitis, with duplex scanning of the veins of the lower limbs, there was an insignificant expansion of the diameter of deep and superficial veins after laparoscopic cholecystectomy. In patients with concomitant pathology of the veins of the lower extremities in the postoperative period, the results obtained with duplex scanning of the veins were most pronounced, which led to both preoperative and postoperative measures to prevent thromboembolic complications and perform simultaneous surgical interventions. The results confirmed the need for surgical intervention for varicose veins of the lower limbs in patients with chronic calculous cholecystitis, which is necessary for the prevention of development in the postoperative period of thrombosis, and then possible later pulmonary embolism.
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