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Khirurgii

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Year 2008 Vol. 16 No 4

GENERAL AND SPECIAL SURGERY

EREMEYEV A.G., GOLUBEV A.A., VOLKOV S.V., VORONOV S.N.

13-YEAR EXPERIENCE OF LAPAROSCOPIC OPERATION APPLICATION IN THE TREATMENT OF CALCULOUS CHOLECYSTITIS PATIENTS

The results of 13-year application of laparoscopic operations in the treatment of the calculous cholecystitis patients are presented. During a 13-year period (from 1994 till 2007) 5468 laparoscopic cholecystectomies (LCE) were performed. A general characteristic of the performed LCE is given. There were 44 (0,8%) conversions. The main reason of conversions was the perivesical infiltrate – in 20 cases. The analysis of the immediate results with the application of Jannet classification (1994) was carried out. Severe complications after LCE were analyzed which required the use of invasive methods. Among them subhepatic abscesses made up 8 (0,14%), iatrogenic damages of extrahepatic bile vessels – 6 (0,1 %), cystic duct stump incompetence – 8 (0,14 %), bile leakage from the gallbladder space – 2 (0,03 %), bleedings from the gallbladder space – 6 (0,1 %). There were lethal outcomes in 4 (0,07%) cases. The straight cause of death in all these cases was heavy thromboembolism of the pulmonary artery in the 2nd and 4th day of the postoperative period. The complex of actions is used to prevent tromboembolic complications; it is aimed to both strengthen immunity of a patient and to decrease negative effects during the surgery.

Keywords: cholecystitis, laparoscopic cholecystectomy, carboxyperitoneum, complications
p. 46 – 49 of the original issue
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