ORGANIZATION OF SURGICAL TREATMENT OF PATIENTS WITH GALL STONE DISEASE
Introduction: The prevalence of cholelithiasis in the population is as high as 15%, with no downward trend in the number of patients affected. The organisation of surgical care is central to the effectiveness of treatment.
Objective: To optimise the organisation of surgical treatment and rehabilitation of patients with cholelithiasis.
Materials and methods: Cross-sectional, clinical, controlled study conducted at the University Hospital NСJSC «Semey Medical University», NCJSC, polyclinic no. 3, 7, 12 and CDP UH SMU, NCJSC for the period 2016-2020. Patients comparable in number, sex, age (n=110) were divided: main and control groups, (n=54 and n=56 respectively). Patients were hospitalized according to "The algorithm of management of patients with acute calculous cholecystitis at different stages of diagnosis and treatment", for which copyright certificate Republic of Kazakhstan №17129 from "30" April 2021 was received. And compared with patients hospitalized without algorithm. The Kolmogorov-Smirnov criterion was used to test the groups for the normality of the distribution. The following indicators of variation statistics were also determined: arithmetic mean (M), median (Me), 25th (P25) and 75th (P75) percentages (quartiles Q1 and Q3). The numerical values in the work are given in the form of M (Me, Q1, Q3). For quantitative variables due to the nature of the distribution, nonparametric methods of statistical analysis: The Mann–Whitney criterion (U). The value of p<0.05 was taken as statistically significant.
Results: Patients' age ranged from 26 to 75 years, mean age was 51±1.5 years, women were 46 (85.2%) and men 8 (14.8%), in the control group women were 44 (78.6%) men 12 (21.4%). All patients underwent surgery. Compared to the main group after 1 month in the control group we observed a decrease of the following indicators (P<0,05): physical performance (PP), pain syndrome (PS), social role (SR), integral index of the quality of life (QL), QL-physical health (PH); the change of such criterion as PS was the most significant (P<0,01). Integral index in the main group increased early after cholecystectomy, and in the control group became significantly lower due to physical state (PhS), PhS and emotional state (ES) (P<0,05). Presented data testify to the positive influence of the algorithm of management, treatment and rehabilitation of patients with acute calculous cholecystitis on the quality of life of the operated patients. This influence was the most noticeable, clear and significantly more expressed after 1 and 6 months after operation.
Conclusions: Optimization of the organization of surgical treatment and rehabilitation made it possible to reduce the duration of preoperative preparation, as well as to reduce the time of surgical intervention to 42.3±1.4 min (Md=42.5, Q1-33.7, Q3-50). At 6 months’ postoperative period the patients in the main group rated their quality of life more highly than the patients in the control group.
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Aimagambetov M.Zh., Omarov N.B., Bulegenov T.A., Akhmetov A.Zh., Auenov M.A., Abdrakhmanov S.T., Masalov A.E., Tayburov R.K., Zhussupov S.M., Masalova Zh.А., Zhamaldinov R.F., Noso Yo. Organization of surgical treatment of patients with gall stone disease // Nauka i Zdravookhranenie [Science & Healthcare]. 2022, (Vol.24) 5, pp. 113-126. doi 10.34689/SH.2022.24.5.015Related publications:
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