RESULTS OF IMPROVEMENT OF DIAGNOSIS AND OPTIMIZATION OF SURGICAL TREATMENT OF ACUTE DESTRUCTIVE CALCULAR CHOLECYSTITIS IN PATIENTS WITH EXCESSIVE BODY WEIGHT AND OBESITY
Introduction: Acute calculous cholecystitis (ACC) is considered one of the important problem of surgery, there is a tendency that ACC is going to be ahead of acute appendicitis statistics. Complications according to Clavien 4 were significantly more frequent among obese patients with acute cholecystitis and there were more open operations.
Objective: To improve the results of diagnostics and surgical treatment of acute destructive calculous cholecystitis in overweight and obese patients.
Research methods: A controlled clinical study of n = 530 cases were carried out in patients with ACC who were treated in the clinic of the University hospital of the non-profit joint-stock company "Semey Medical University" in the surgical department. For patients with a diagnosis of acute calculous cholecystitis (ACC), the body mass index (BMI) was determined. Ultrasound examination (US) was carried out in a new way, along with general clinical studies and ultrasound of the abdominal organs. Comparative analysis of ultrasound data in 34 (n = 34) patients in the CGP at the Aksus Central Hospital in Aksu, Pavlodar region for acute calculous cholecystitis (ACC).
Results: Among patients with ACC (n = 530), the prevalence of women 389 (73.4%), and patients of working age prevail. Patients with a BMI higher than 25.00 and with obesity - 407 patients (76.79%). Of these, 186 (45.70%) - pre obesity, 157 (38.57%) - grade I obesity, 44 (10.81%) - grade II obesity, and 20 (4.92%) cases revealed grade III obesity. In n = 34 patients with overweight and obesity, a new ultrasound method was used, where visualization improved in 29 (85.29%) patients. Operated with: mini-assistant Liga 7 - 176 (43.24%), universal retractor for patients with overweight and obesity (UR-IMTO) - 97 (23.83%), laparoscopic cholecystectomy (LCE) - 95 (23.34%), traditional cholecystectomy (TChE) - 39 (9.58%).
Conclusions: 389 women (73.4%) predominate with ACC, both in patients of working age and in patients with a BMI over 25.00 and with obesity. The method of ultrasound diagnostics of ACC improves diagnostics in patients with overweight and obesity, in 85.29%. The method of dissociation of the CDS together with the retractor developed in the clinic for patients with overweight and obesity with acute destructive calculous cholecystitis improves the results of treatment.
Meirbek Zh. Aimagambetov 1, https://orcid.org/0000-0003-4699-8200
Samatbek T. Abdrakhmanov 1, https://orcid.org/0000-0002-4270-3498
Nazarbek B. Omarov 1, http://orcid.org/0000-0002-6201-8263
Medet A. Auenov 1, https://orcid.org/0000-0002-1809-9091
Yoshihiro Noso2, http://orcid.org/0000-0003-3477-126
Askar Zh. Akhmetov3 , https://orcid.org/0000-0001-9241-5294
Erlan M. Asylbekov 3, https://orcid.org/0000-0002-7739-1041
Symbat B. Zhanysbay1, https://orcid.org/0000-0003-3386-1416
1 Department of Hospital Surgery, NСJSC «Semey Medical University», Semey, Republic of Kazakhstan;
2 Department of Medical Management, Hiroshima International University in Hiroshima, Hiroshima, Japan;
3 University Hospital, NСJSC «Semey Medical University», Semey, Republic of Kazakhstan;
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Aimagambetov M.Zh., Abdrakhmanov S.T., Omarov N.B., Auenov M.A., Noso Yo., Akhmetov A.Zh., Asylbekov E.M., Zhanysbay S.B. Results of improvement of diagnosis and optimization of surgical treatment of acute destructive calcular cholecystitis in patients with excessive body weight and obesity // Nauka i Zdravookhranenie [Science & Healthcare]. 2020, (Vol.22) 5, pp. 100-108. doi 10.34689/SH.2020.22.5.010Related publications:
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