Novosti
Khirurgii

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Year 2021 Vol. 29 No 2

GENERAL & SPECIAL SURGERY

O.L. TKACHUK, R.L. PARAKHONIAK

ARGON APPLICATION FOR CREATION OF PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERIES

Ivano-Frankivsk National Medical University, Ivano-Frankivsk,
Ukraine

Objective. To advance the patients’ rehabilitation after laparoscopic surgeries by using insufflation with argon gas for pneumoperitoneum formation.
Methods. The given study is the investigation of sequentially admitted 360 patients with gallstone disease (cholelithiasis). The patients have been randomly divided into 4 groups: Group 1 – uncomplicated gallstone disease, carboxyperitoneum (n=192); Group 1a – acute cholelithiasis (n=37), carboxyperitoneum; Group 2 – uncomplicated gallstone disease, argonperitoneum (n=102); Group 2a – acute cholelithiasis (n=29), argonoperitoneum. All the patients have undergone laparoscopic cholecystectomies. Subjective assessment of the pain syndrome intensity has been studied on the basis of patient-reported outcomes questionnaire according to the visual analogue scale (VAS), need for analgesic injections, presence and intensity of the shoulder pain syndrome as well as the duration of in-patient treatment.
Results. In accordance with patient-reported outcomes (with argonperitoneum application) subjective pain sensation has proved to decrease by 1.5-2 fold. On the first day of the postoperative period both in uncomplicated gallstone disease and in acute cholelithiasis, argonperitoneum has statistically significantly reduced the need for analgesics. Pain in the shoulder girdle (omalgia) was observed in 48.9% of the patients having been applied carboxyperitoneum whereas it was noticed in only 5.3% of the patients having been applied argonperitoneum during the operation. Argonperitoneum application statistically significantly reduces in-patient treatment period by 30% (from 2.3 - to 1.6 days) in uncomplicated gallstone disease and by 23% (from 4.3 - to 3.3 days) in gallstone disease complicated by acute cholelithiasis.
Conclusion. Application of argon for pneumoperitoneum formation in laparoscopic cholecystectomies reliably reduces pain syndrome intensity in the postoperative period. The number of postoperative omalgia cases is reduced by 42% in patients having undergone cholecystectomies with argonperitoneum application. Application of argonperitoneum in management of patients with cholelithiasis may reduce the hospitalization period by 25-30%.

Keywords: cholecystitis, laparoscopic cholecystectomy, artificial pneumoperitoneum, argon, postoperative period, postoperative pain
p. 167-174 of the original issue
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Address for correspondence:
76000, Ukraine,
Ivano-Frankivsk, Halytska Str., 2,
Ivano-Frankivsk National Medical University,
the Surgery Department of Postgraduate Education,
tel. +38 (066) 592 95 89,
e-mail: rostykpar@gmail.com,
Parakhoniak Rostyslav L.
Information about the authors:
Tkachuk Oleh L., MD, Professor, Head of the Surgery Department of Postgraduate Education, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
http://orcid.org/0000-0002-9216-4605
Parakhoniak Rostyslav L., Postgraduate Student of the Surgery Department of Postgraduate Education, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
http://orcid.org/0000-0002-3230-9331
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