THE RESULTS OF A COMPARATIVE ANALYSIS OF SURGICAL METHODS FOR THE TREATMENT OF COMPLICATIONS OF CHOLELITHIASIS
Introduction: Over the past decades, there has been an increase in diseases of the hepatopancreatoduodenal zone, including cholelithiasis (hereinafter referred to as cholelithiasis). GSD complicated by acute cholecystitis is a common surgical pathology that develops as a result of obstruction of the bile ducts. The risk of gallbladder disease is increased in women, obese patients, pregnant women, and patients 40 years of age or older. About 95% of people with acute cholecystitis have gallstones. Without timely treatment, acute cholecystitis can lead to perforation of the gallbladder, peritonitis, sepsis, or death. In connection with the widespread introduction of endovideosurgery, the number of operations performed on the gallbladder and bile ducts has increased.
Aim. To conduct a comparative analysis of the effectiveness of endovideosurgical methods for the treatment of cholelithiasis complications.
Materials and methods: For the period 2020 – 2021 in the departments of general surgery of the "Multi-profile city hospital No. 1" and "City multi-profile hospital No. 2" of the city of Astana of the Republic of Kazakhstan, the experience of surgical treatment of complication of cholelithiasis was studied. The results of surgical treatment of complicated forms of cholelithiasis in 1401 patients were studied. The age of patients varied from 28 to 90 years; there were 510 men (36.4%), women 891 (63.6%). All patients were admitted on an emergency basis with an acute abdomen. Upon admission, patients were examined in full, in accordance with the Clinical Protocol of the Ministry of Health of the Republic of Kazakhstan
Statistical analysis of the results was carried out using the methods of variation statistics with the calculation of М±SD. Differences between comparisons groups were analyzed using standard deviation.
Results: In 99% of cases, a minimally invasive method was used to treat complications of cholelithiasis. Laparoscopic cholecystectomy with revision and drainage of the biliary tract was performed in 77%, then in terms of the frequency of choice of the surgical method: ERCP with EPST - 18%, PTCS in 4% of cases. In 1% of cases a conversion was used: laparotomy with the imposition of biliodigestive anastomoses.
Conclusion: The gold standard of surgical treatment of cholelithiasis and its complications remains laparoscopic cholecystectomy and ERCP with EPST.
Kulsara R. Rustemova1, https://orcid.org/0000-0002-8853-9267
Nurbek Igisinov1, https://orcid.org/0000-0002-2517-6315
Marat K. Syzdykbaev2, https://orcid.org/0000-0002-0561-4111
Batyr A. Aitmoldin3, https://orcid.org/0000-0001-7908-367
Sagynysh Zh. Zhylkaydar3, https://orcid.org/0000-0002-5226-5479
Zhanara Kakenova3, https://orcid.org/0000-0001-8708-2042
Bolat Sh. Suleimenov3, https://orcid.org/0000-0002-4821-1371
Assem R. Shakeyeva3, https://orcid.org/0000-0003-3391-3263
Maryam E. Musinova3,https://orcid.org/0000-0001-9078-4336
1 NJSC "Astana Medical University", Department of Surgical Diseases with a course of cardiothoracic surgery and maxillofacial surgery, Astana, Republic of Kazakhstan;
2 NJSC "Semey Medical University", Department of hospital surgery, anesthesiology and resuscitation, Semey, Republic of Kazakhstan;
3 City multidisciplinary hospital №2, Astana, Republic of Kazakhstan.
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Rustemova K.R., Igisinov N., Syzdykbaev M.K., Aitmoldin B., Zhylkaydar S., Kakenova Zh., Suleimenov B., Shakeyeva A.R., Musinova M.E. The results of a comparative analysis of surgical methods for the treatment of complications of cholelithiasis // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 3, pp. 113-120. doi 10.34689/SH.2023.25.3.015Related publications:
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