Danyliuk M.B., Zavgorodni S.M., Kubrak M.A., Yareshko N.O., BachurinA.V., Pertsov I.V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The purpose of the work is to evaluate the effectiveness of the impact of preoperative preparation of elderly and senile patients on the severity of the inflammatory process in the gallbladder wall by assessing morphological changes. The work included 153 elderly and senile patients with acute cholecystitis on the background of cholelithiasis. All patients were urgently hospitalized in the surgical department with gynecology beds of the emergency hospital, with clinical symptoms of acute cholecystitis. Confirmation of the clinical diagnosis was carried out using ultrasound and blood tests. The comparison group consisted of 89 (58,2 %) patients, whose perioperative treatment was carried out in accordance with the standards and clinical protocols of the medical institution. The main group – 64 (41,8 %) patients, whose preoperative preparation was carried out according to the algorithm developed at the Department of General Surgery and Postgraduate Surgical Education, Zaporozhye State Medical University. The average duration of preoperative preparation in both groups was equivalent, in the comparison group it was 26,00 (7,00; 27,00) hours, in the main group 24,00 (21,00; 37,00) hours, U=2305,50, p=0,0570. The average duration of surgery in the comparison group was 60,00 (50,00; 80,00) minutes, in the main group 35,50 (30,00; 50,00) minutes. Carrying out preoperative work according to the developed algorithm significantly reduced the number of destructive forms of acute cholecystitis. The incidence of gangrenous inflammation in the comparison group was 30 (33,7 %) cases, while in the main group only 9 (14,2 %), U=2256,50, p=0,0288. In turn, the frequency of chronic cholecystitis in a state of exacerbation increased, in the comparison group 12 (13,5 %), and in the main group 25 (39,0 %), U=2119,50, p=0,0071, which confirms the suspension inflammatory. process when using the developed algorithm. Conclusions. The use of preoperative preparation, according to the developed algorithm, significantly reduced the incidence of destructive forms of acute cholecystitis. Prevention of the development of infiltrative changes and diffuse and diffuse peritonitis made it possible to predominantly use minimally invasive methods of treatment. The preoperative preparation did not affect the duration of the preoperative period.

acute cholecystitis, old age, senile age, algorithm.

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«Bulletin of problems biology and medicine» Issue 2 Part 1 (164), 2022 year, 135-144 pages, index UDK 616.366–002–091.8–053.9–089.163

10.29254/2077-4214-2022-2-1-164-135-144