Intraabdominal bleedings after various options of cholecystectomy

  • № 1 2018

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Язык: английский

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Аннотация

Как показал обзор литературы, ведущее место среди внутрибрюшных осложнений после различных вариантов холецистэктомии занимают послеоперационные кровотечения, в структуре послеоперационных осложнений составляющие около 4%. Причины возникновения внутрибрюшных кровотечений после холецистэктомии различны, однако наиболее часто ими становятся плохое качество и техника выполнения оперативных вмешательств, недостаточно тщательный и надежный интраоперационный гемостаз. Отечественные и зарубежные авторы отмечают, что признаки внутрибрюшных кровотечений в билиарной хирургии наиболее легко выявляются с помощью эхографии, которая благодаря своей неинвазивности, быстроте выполнения, высокой чувствительности считается методом скрининга. Точность установления наличия внутрибрюшных кровотечений и гематом после холецистэктомии во много раз возрастает при применении КТ и МСКТ в режиме 3D-реконструкции.

Ҳар-хил вариантдаги холецистэктомиядан кейин кўп учрайдиган асорталардан бири – бу операциядан кейинги ички қон кетиш, барча операциядан кейинги асоратларнинг ўртача 4 % ни ташкил этади. Операциядан кейинги қорин бўшлиғи ичи қон кетиши ривожланишининг сабаблари турлича. Кўпчилик авторларнинг маълумотларига кўра энг асосий сабаблардан операцияни бажарилиши техника ва сифати пастлиги, интраоперацион бажарилган гемостазнинг ва эътибор етарлича эмаслигидир. Ҳам маҳаллий, ҳам хорижий муаллифларнинг таъкидлашича билиар жаароҳликда қон кетиш белгилари эхография ёрдамида нисбатан осон аниқланади, эхография ўзининг ноинвазивлиги, бажарилиши тезлиги, қулайлиги, юқори сезувчанлиги туфайли скрининг усули ҳисобланади. Холецистэктомиядан кейинги қорин бўшлиғи ичи қон кетиши ва гематомаларини аниқлаш аниқлиги КТ ва МСКТ 3D-реконструкция режимида фойдаланилганда бир неча баробарга ошади.

As the review of literature has shown, the leading place among intra-abdominal complications after various variants of cholecystectomy is postoperative bleeding, which is about 4% in the structure of postoperative complications. The causes of intraabdominal bleedings after cholecystectomy are different, but most often they are poor quality and technique of performing surgical interventions, insufficiently thorough and reliable intraoperative hemostasis. Domestic and foreign authors note that signs of intraabdominal bleedings in biliary surgery are most easily detected with the help of echography, which due to its noninvasiveness, speed of execution, high sensitivity is considered as a screening method. The use of CT and MSCT in 3D reconstruction much more increases accuracy of establishing the presence of intra-abdominal bleedings and hematomas after cholecystectomy.

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