COMPARATIVE ASSESSMENT OF RESULTS OF A TRADITIONAL AND LAPAROSCOPIC CHOLECYSTECTOMY
Aim. ^mpa^^e assessment of effectiveness of a traditional and laparoscopic cholecystectomy at a cloelithiasis. Materials and methods. Under our observation over the period of 1997-2012 there were 1772 patients with acute and chronic calculous cholecystitis (a basic group with application of a laparoscopic cholecystectomy - 1462, control group with application of a traditional cholecystectomy - 310, men - 130, women - 1642). All patients conducted complex examination: clinical analysis, radiological, ultrasonography, instrumental and morphological research. Results. We carried out the comparative analysis of results of laparoscopic and traditional cholecystectomy. Complications in a basic group: empyema (10,2%), edema of a gall bladder (7,8%), paravesical infiltrate (4,5%), phlegmon of a gall bladder (2,8%), and in control group: local peritonitis - 12%; empyema of a gall bladder - 11,1% and an edema of a gall bladder - 6,8%. Duration of a laparoscopic cholecystectomy was averaged by 42,3±3,2 minutes. Intraoperative complications: bleeding from a vesical artery and a bubble bed (2,73%), a trauma of the choledochus (0,27%) and in 1 one case damage of a duodenum. The average percentage of conversion was (5,7%). Conversion reasons: existence of the inflammatory infiltrate in a neck of a gall bladder (28,9%), extensive adherent process in an abdominal cavity (20,5%) and bleeding from a vesical artery and a bed of a gall bladder (19,3%), technical difficulties, a choledocholithiasis and fistula of choledochus-bladder. Postoperative complications: wound suppuration, expiration of bile, bleeding, pancreatitis. Lethality: at a laparoscopic cholecystectomy - 3 (0,21%), at traditional - 2 (0,65%). Conclusion. The laparoscopic cholecystectomy is the most rational way of surgical treatment of patients with cloelithiasis and its complications that is caused by less injury, a low percentage of complications, lethalities, reduction of terms and the material inputs on treatment and rehabilitation of patients.