COMPARATIVE ASSESSMENT OF RESULTS OF A TRADITIONAL AND LAPAROSCOPIC CHOLECYSTECTOMY
COMPARATIVE ASSESSMENT OF RESULTS OF A TRADITIONAL AND LAPAROSCOPIC CHOLECYSTECTOMY
Nazarov F.N., Akhmedov A., Gulmuradov T.G.
Derartment of surgery of Kurgan-Tyube office of State educational establishment «Institute of postgraduate education in health sphere of Republic of Tajikistan», Kurgan-Tyube
Aim. Сomparative assessment of effectiveness of a traditional and laparoscopic cholecystectomy at a cloelithiasis.
Materials and methods. Under our observation over the period of 1997-2012 there were 1772 patients with acute and chronic calculous cholecystitis (a basic group with application of a laparoscopic cholecystectomy — 1462, control group with application of a traditional cholecystectomy — 310, men — 130, women — 1642).
All patients conducted complex examination: clinical analysis, radiological, ultrasonography, instrumental and morphological research.
Results. We carried out the comparative analysis of results of laparoscopic and traditional cholecystectomy. Complications in a basic group: empyema (10,2%), edema of a gall bladder (7,8%), paravesical infiltrate (4,5%), phlegmon of a gall bladder (2,8%), and in control group: local peritonitis — 12%; empyema of a gall bladder — 11,1% and an edema of a gall bladder — 6,8%. Duration of a laparoscopic cholecystectomy was averaged by 42,3±3,2 minutes.
Intraoperative complications: bleeding from a vesical artery and a bubble bed (2,73%), a trauma of the choledochus (0,27%) and in 1 one case damage of a duodenum.
The average percentage of conversion was (5,7%). Conversion reasons: existence of the inflammatory infiltrate in a neck of a gall bladder (28,9%), extensive adherent process in an abdominal cavity (20,5%) and bleeding from a vesical artery and a bed of a gall bladder (19,3%), technical difficulties, a choledocholithiasis and fistula of choledochus-bladder.
Postoperative complications: wound suppuration, expiration of bile, bleeding, pancreatitis.
Lethality: at a laparoscopic cholecystectomy — 3 (0,21%), at traditional — 2 (0,65%).
Conclusion. The laparoscopic cholecystectomy is the most rational way of surgical treatment of patients with cloelithiasis and its complications that is caused by less injury, a low percentage of complications, lethalities, reduction of terms and the material inputs on treatment and rehabilitation of patients.
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