TAKING INTO ACCOUNT THE MORPHO-FUNCTIONAL CHANGES IN THE COMPONENTS OF THE TRIANGLE OF CALLO IN ACUTE CHOLECYSTITIS AND THEIR INFLUENCE ON THE FEATURES OF THE LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

At the acute cholecystitis of loud speaker of infl ammatory process in a hepatobiliary one quickly acquires the dangerous display of the infi ltration-used for setting fi re character. Such changes in the zone of triangle of Callot’s predetermine the increase of risk of sub- and postoperative complications.Research aim: to learn the features of infl uence of anatomic changes in the zone of triangle of Callot’s at a sharp destructive cholecystitis and to defi ne the optimal list of operative- technic’s assures at implementation of cholecystectomy.Material and methods. From 2018 to 2023, in the surgical department of the Storozhynets Multidisciplinary Hospital for Intensive Care studied 89 (100 %) patients who were operated on for acute cholecystitis.Resalts. In the course of treatment and examination, the infl uence of the infl ammatory process in acute cholecystitis on the nature of anatomical changes in the area of the Callot’s triangle was studied. In order to avoid suboperative complications during laparoscopic cholecystectomy, 18 step-by-step operational and technical measures were identifi ed, which served as criteria for the safe performance of laparoscopic cholecystectomy in acute cholecystitis. It was established that the optimal variant of laparoscopic cholecystectomy for chronic cholecystitis according to the method of Stephen Strasberg (1992), Gary G. Wind (1999), in case of destructive changes in the area of the Callot’s triangle, is inferior to the «elephant trunk» method, which is more practical in such circumstances.Conclusion. Suboperative consideration of the step-by-step implementation of certain tactical and therapeutic measures made it possible to avoid postoperative complications in all operated patients 89 (100 %). Observance of such techniques during laparoscopic cholecystectomy creates conditions for its eff ective implementation, both in chronic and acute cholecystitis.