Online ISSN: 3007-0244,
Print ISSN:  2410-4280
RESULTS OF IMPROVEMENT OF SURGICAL TREATMENT IN THE SYNDROME OF MECHANICAL JAUNDICE OF BENIGN ORIGIN
Introduction: The problem of diagnosis and surgical treatment of benign mechanical jaundice remains relevant due to the development of severe complications leading to death. Aim: Analysis of the improvement of the results of surgical treatment of patients with obstructive jaundice syndrome of benign genesis. Materials and research methods: The study analyzed the results of surgical treatment of 142 patients with cholelithiasis complicated by mechanical jaundice of benign origin, who were treated in the period from 2015 to 2019. Of these, 47 were men (33.1%), 95 were women (66.9%). The average age was 64.5±5.4 years. All patients were divided into two groups (main and comparison), depending on the treatment method used. Results: In the postoperative period, the following complications were observed. In total, 5 complications were observed in the main group (7.2%) in 5 patients( 7.2%), and only in 1 case a complication of the second degree of severity was determined according to the classification used (postoperative pancreatitis) Clavien-Dindo. In the comparison group, 18 (24.7%) different complications included in the classification occurred in 13 patients (17.8%). The differences between the groups were statistically significant (χ2=7,922, p=0.005). There were no fatalities in the main group. In the comparison group, there were 4 fatal outcomes (5.5%), the causes of which were: in 2 cases, hepatic-renal failure on the background of severe intoxication, in 1 case, massive pulmonary embolism, in 1-disseminated intravascular coagulation syndrome (complications developed on the 2-3 day after surgery). The differences between the groups on this indicator did not reach the degree of significance. Conclusions: The developed surgical instruments and methods of surgical treatment of mechanical jaundice of benign origin allowed to improve the results of treatment by 2.9 times (t=0.045) in the group of patients and 2.3 times in the group with Mirizzi syndrome type III-IV (t=0.048), as well as to reduce the level of inflammatory and pain syndrome, the duration of hospitalization and reduces the number of restenoses.
Meirbek Zh. Aimagambetov1, https://orcid.org/0000-0003-4699-8200 Medet A. Auyenov1, https://orcid.org/0000-0002-1809-9091 Nazarbek B. Omarov1, http://orcid.org/0000-0002-6201-8263 Tolkyn A. Bulegenov1, https://orcid.org/0000-0001-6145-9649 Yoshihiro Noso2, http://orcid.org/0000-0003-3477-1260 Samatbek T. Abdrakhmanov1, https://orcid.org/0000-0002-4270-3498 Yerlan M. Asylbekov3, https://orcid.org/0000-0002-7739-1041 Askar Zh. Akhmetov3, https://orcid.org/0000-0001-9241-5294 Аldiyar Y. Мasalov1, http://orcid.org/0000-0002-2844-037Х 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., Auyenov M.A., Omarov N.B., Bulegenov T.A., Noso Y., Abdrakhmanov S.T., Asylbekov Ye.M., Akhmetov A.Zh., Мasalov А.Y. Results of improvement of surgical treatment in the syndrome of mechanical jaundice of benign origin // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 2, pp. 92-102. doi 10.34689/SH.2021.23.2.009

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