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Algorithm for the management of patients with bile duct after cholecystectomy
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DAVLATOV SALIM SULAYMONOVICH, RAKHMANOV QOSIM ERDANOVICH, SAYDULLAEV ZAYNIDDIN YAXSHIBOYEVICH, SHERBEKOV ULUGBEK AKHRAROVICH
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| Abstract:
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Relevance. Cholecystectomy is the most frequent operation, and the number of cholecystectomies performed annually exceeds 500 thousand. In Uzbekistan, the number of cholecystectomies performed annually exceeds 10 thousand, which is second only to hernia repair in all abdominal operations. Purpose of the study. To optimize diagnostic and surgical tactics in patients with bile duct after cholecystectomy in the early postoperative period by introducing modern diagnostic and minimally invasive treatment methods. Material and research methods. We analyzed the results of surgical treatment of 2268 patients who underwent cholecystectomy in the 1st clinic of the Samarkand State Medical Institute in the period 2010-2019. Of these, 967 patients underwent laparoscopic cholecystectomy, 874 patients underwent cholecystectomy from mini-access, and 427 patients underwent open cholecystectomy. The results of the study. After the differentiated course of treatment among 52 patients with bile leakage, various complications in the early postoperative period were noted in 5.8% of patients. In the long-term postoperative period, strictures of the pancreas and arterial hypertension were observed in 7.6% of patients. Findings. Ultrasound is the initial method for diagnosing postoperative bile flow. With bile duct 1 degree, the absence of signs of peritoneal irritation and intoxication symptoms, it is necessary to adhere to the tactics of active dynamic observation. With bile ducts of the 2nd to 3rd degree, repeated intervention is indicated - laparoscopy, laparotomy. After the differentiated course of treatment among 52 patients with bile leakage, various complications in the early postoperative period were noted in 5.8% of patients. In the long-term postoperative period, strictures of the pancreas and arterial hypertension were observed in 7.6% of patients. Findings. Ultrasound is the initial method for diagnosing postoperative bile flow. With bile duct 1 degree, the absence of signs of peritoneal irritation and intoxication symptoms, it is necessary to adhere to the tactics of active dynamic observation. With bile ducts of the 2nd to 3rd degree, repeated intervention is indicated - laparoscopy, laparotomy. After the differentiated course of treatment among 52 patients with bile leakage, various complications in the early postoperative period were noted in 5.8% of patients. In the long-term postoperative period, strictures of the pancreas and arterial hypertension were observed in 7.6% of patients. Findings. Ultrasound is the initial method for diagnosing postoperative bile flow. With bile duct 1 degree, the absence of signs of peritoneal irritation and intoxication symptoms, it is necessary to adhere to the tactics of active dynamic observation. With bile ducts of the 2nd to 3rd degree, repeated intervention is indicated - laparoscopy, laparotomy. strictures of the pancreas and arterial hypertension were observed in 7.6% of patients. Findings. Ultrasound is the initial method for diagnosing postoperative bile flow. With bile duct 1 degree, the absence of signs of peritoneal irritation and intoxication symptoms, it is necessary to adhere to the tactics of active dynamic observation. With bile ducts of the 2nd to 3rd degree, repeated intervention is indicated - laparoscopy, laparotomy. strictures of the pancreas and arterial hypertension were observed in 7.6% of patients. Findings. Ultrasound is the initial method for diagnosing postoperative bile flow. With bile duct 1 degree, the absence of signs of peritoneal irritation and intoxication symptoms, it is necessary to adhere to the tactics of active dynamic observation. With bile ducts of the 2nd to 3rd degree, repeated intervention is indicated - laparoscopy, laparotomy.
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| Keyword:
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gall bladder, cholecystectomy, complication, bile leakage, relaparotomy, algorithm.
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2020.SP2.004
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