CRITERIA FOR ASSESSING IMMEDIATE AND LONG-TERM RESULTS OF LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

The high prevalence of cholelithiasis, the increase in the number of elderly and senile patients, as well as the widespread concomitant cardiovascular, endocrine and metabolic diseases cause a steady increase in the number of patients with complicated forms of gallbladder inflammation, as written in their work by scientists from Uzbekistan [1,3,5,7,9,11,13], representing the Bukhara State Medical Institute, and they noted that the presence of multiple concomitant pathologies, a decrease in the functional reserves of the body and a high frequency of complicated forms of the disease significantly complicate both the diagnostic process and the decision-making process on choosing the optimal method of surgical treatment, which is also emphasized by Russian scientists, for example, from the Far Eastern State Medical University [2,4,6,8,10] and Novosibirsk National Research State University [3,15,17,19], and employees of the Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan N.D. Mukhiddinov et al. [2,14,16,18] having studied the results of treatment of 95 patients with ACC showed that when choosing surgical tactics it is necessary to take into account not only the form of the inflammatory process, but also the nature of local anatomical changes, and when analyzing the results of open interventions, complications of the early postoperative period were recorded in 22.5% of patients, and the mortality rate reached 7.5%, which leads to an increase in publications where LHEC is considered as the main method of surgical treatment of ACC, and the accumulated world experience indicates that the use of minimally invasive technologies can significantly reduce surgical trauma, reduce the duration of hospitalization and reduce the frequency of postoperative complications compared to traditional interventions, as written by researchers from the Beijing Union Medical College and the Chinese Academy of Medical Sciences Q. Liu et al. [20,21,22,23].

It should be noted that the presented studies focused primarily on the factors that contribute to difficult laparoscopic cholecystectomy, the reasons for access conversion, individual intraoperative complications, and improving the technical aspects of the procedure. However, the patterns of sequential development of unfavorable laparoscopic cholecystectomy outcomes, which integrate clinical, instrumental, and intraoperative changes into a single pathogenetic chain of complications, remain insufficiently studied.