Диагностика и лечение ранних внутрибрюшных осложнений после холецистэктомии: 20-летний опыт клиники

https://doi.org/10.54185/TBEM/vol14_iss5/a1

Abstract

In the RNCEMP for the period 2001 to 2019 10218 surgeries were performed for acute and complicated
forms of cholelithiasis (GSD), after which clinically significant early intra-abdominal complications (ERBO),
requiring repeated endobiliary, laparoscopic or open interventions, were noted in 260 (2.5%) patients. The
frequency of RVBO after emergency cholecystectomy averages 2.5% with a range from 1.8% (after LCE) to
3.3% (after conventional CE) and 4.6% (after minilaparotomic CE). With cholecystectomy, the frequency of
iatrogenic damage to hepaticocholedochus ranges from 0.7-0.8%. In the structure of RVBO requiring repeated
interventions, complications associated with a violation of the integrity of the ductal system prevail: in 41.9%
of cases, there is an external (23.8%) or intra-abdominal (18.1%) bile leakage, in 26.2% of cases - damage to the
main extrahepatic bile ducts; followed by intra-abdominal bleeding (16.2%) and abdominal abscesses (15.8%).
In RVBO after operations on the bile ducts, in 63.1% of cases, the existing complications can be eliminated
using endobiliary interventions (19.7%), endovideosurgical techniques (35.2%) and a hybrid application of
two endoscopic technologies - videolaparoscopy and endoscopic transpapillary stenting of the choledochus
(8.2%).