FEATURES OF VENOUS THROMBOEMBOLISM PREVENTION IN PATIENTS WITH ACUTE CALCULOUS CHOLECYSTITIS
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i1.15250Keywords:
thromboembolic complications, acute calculous cholecystitis, laparoscopic cholecystectomyAbstract
SUMMARY. Prevention of venous thromboembolism after laparoscopic surgeries is of great importance for maintaining patients’ health. The occurrence of such complications has become increasingly common in recent years.
The aim – to improve the outcomes of prevention and treatment of thromboembolic complications in patients with acute calculous cholecystitis.
Material and Methods. An analysis was conducted on the diagnosis and treatment of 300 patients who underwent laparoscopic surgery for gallstone disease at the Regional Center for Planned Surgery and Transplantology of the Rivne Regional Clinical Hospital named after Yu. Semenyuk ROR from 2019 to 2023. All patients were divided into two groups: Group I included 162 (54 %) patients who received thromboprophylaxis after laparoscopic cholecystectomy according to approved thromboprophylaxis protocols, while Group II consisted of 138 (46 %) patients who received thromboprophylaxis based on a developed algorithm as part of this study. The risk stratification showed that 57 (19 %) cases had a minimal risk (0 points), 204 (68 %) had a low risk (1–2 points), 31 (10.3 %) had a moderate risk (3–4 points), and 8 (2.7 %) had a high risk (≥5 points).
Results. During the study of fibrinogen concentration levels, it was found that in patients with concomitant lower limb venous pathology, this indicator increased postoperatively compared to other groups (preoperatively, it was 4.0 g/L, while postoperatively, it increased to 4.2 g/L in men and 4.3 g/L in women). In patients classified according to the J. Caprini scale, the preoperative fibrinogen concentration levels ranged from 3.4±0.22 to 4.3±0.19 g/L, whereas postoperative values were as follows: in the control group – from 3.7±0.13 g/L (p<0.05) to 4.4±0.14 g/L (p<0.05), and in the main group – from 3.5±0.3 g/L (p<0.05) to 4.2±0.12 g/L (p<0.05).
Conclusions. Risk assessment of venous thromboembolism (VTE) and thromboembolic events (TEE) based on the modified J. Caprini risk assessment model allows for a more precise and individualized approach to the prevention and treatment of venous thromboembolism.
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