Abstract
Abstract. Relevance. According to the World Health Organization, in the world due to the increase in the incidence of cholelithiasis, there is an increase in the number of patients with destructive forms of this pathology. The aim of the study is to improve the quality of treatment of patients with acute destructive cholecystitis by improving surgical tactics. Materials and research methods. The work is based on the assessment of the results of surgical treatment of patients with acute destructive cholecystitis who were treated in the surgical departments of the 1st clinic of the Samarkand State Medical Institute (clinical base of the departments of surgical diseases No. 1 and general surgery of the Samarkand State Medical Institute) for the period from 2016 to 2020. Conclusions. The tactics of surgical treatment of patients with destructive cholecystitis, taking into account an integrated approach to the choice of access, made it possible to improve the quality of care by reducing the frequency of immediate postoperative complications from 13.4% (11 patients in the comparison group) to 1.7% (2 patients in the main group).
Highlights
The aim of the work: to improve the quality of treatment of patients with acute destructive cholecystitis by improving surgical tactics
Despite the great success of minimally invasive surgery in the treatment of cholelithiasis, many authors include some destruc tive forms of acute cholecystitis in the group of contraindica tions to performing cholecystectomy from a minila parotomy approach [3, 7]. This is due to the techni cal complex ity of performing cholecystectomy from minilaparotomy access in destructive forms of acute cholecystitis complicated by dense amniotic infiltrate, which often leads to the transition to a wide laparoto my with the development of related complications in the postoperative period [5, 9, 11, 12]
Taking into account the fact that acute destructive cholecystitis is a common complication of the gastro intestinal tract, the development of atypical methods of performing minimally invasive interventions that allow avoiding transitions to a wide laparotomy is of great practical interest [6, 11]
Summary
The aim of the work: to improve the quality of treatment of patients with acute destructive cholecystitis by improving surgical tactics. Despite the great success of minimally invasive surgery in the treatment of cholelithiasis, many authors include some destruc tive forms of acute cholecystitis (phlegmonous and gangrenous cholecystitis with amniotic infiltration in the neck of the gallbladder with a disease duration of more than 72 hours) in the group of contraindica tions to performing cholecystectomy from a minila parotomy approach [3, 7] This is due to the techni cal complex ity of performing cholecystectomy from minilaparotomy access in destructive forms of acute cholecystitis complicated by dense amniotic infiltrate, which often leads to the transition to a wide laparoto my with the development of related complications in the postoperative period [5, 9, 11, 12]. The aim of the work is to improve the quality of treatment of patients with acute destructive cholecys titis by improving surgical tactics
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