NATURE OF POST-SURGERY COMPLICATIONS AFTER CHOLECYSTECTOMY OF DESTRUCTIVE CHOLECYSTITIS IN PATIENTS OF AN OLDER AGE GROUP WITH A ISCHEMIC HEART DISEASE
Аbstract. The significance of the problem of acute cholecystitis in the elderly and senile is due to a high increase in the incidence, the presence of marked concomitant diseases.
There is no literature data on a comparative analysis of early post-surgery complications of acute destructive cholecystitis in elderly and senile patients with concomitant coronary heart disease after traditional cholecystectomy and laparoscopic cholecystectomy.
The Aim of the study is a comparative analysis of the nature of early post-surgery complications after traditional cholecystectomy and laparoscopic cholecystectomy of acute destructive cholecystitis in the elderly and senile with concomitant coronary heart disease.
Materials and methods of research. A comparative analysis of early post-surgery complications was performed in 392 patients aged 60 and over with concomitant coronary heart disease who underwent surgical treatment for acute destructive cholecystitis. Depending on the method of surgical treatment, patients were divided into two groups: the І group (n = 178) — surgical treatment was carried out in the amount of traditional cholecystectomy, sanitation of the abdominal cavity with saline and decasan solution; the ІІ group (n = 214) — surgical treatment included laparoscopic cholecystectomy, sanitation of the abdominal cavity with saline and «decasan» solution, extraction of the gallbladder in a rubber sterile container through a subxiphoid wound, which, after removal of the gallbladder, was sanitized with «decasan» solution.
Research results. Complications from the cardiovascular system in the 1st group were noted in 2.8 % of patients, pneumonia — 1.1 %, from the abdominal cavity — 8.5 %, wounds — 25.8 %, postoperative intestinal paresis — 19, 1 %, mortality — 1.1 %. In the 2nd group, complications from the cardiovascular system — 0.5 %, from the abdominal cavity — 4.7 %, wounds — 4.2 %, postoperative intestinal paresis — 8.4 %, mortality — 0.5 %. Complications related to bile leakage, the development of biloma or biliary peritonitis in the groups did not differ.
Conclusions. The use of laparoscopic cholecystectomy in acute destructive cholecystitis in elderly people with concomitant coronary heart disease has reduced the number of postoperative complications from the cardiovascular system compared with traditional cholecystectomy from 2.8 % to 0.5 %, from the abdominal cavity — from 8.5 to 4.7 %, from the side of the wound — from 25.8 to 4.2 %, reduce mortality from 1.1 to 0.5 %.
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