RESUMEN
Among 259 planned operations on bile ducts 102 operations were performed for complicated cholecystitis and 36 operations for the syndrome after cholecystectomy. Intensive correcting therapy of morphofunctional disorders of the liver and pancreas in the pre- and postoperative period including the intraportal way of infusion as well as the optimal choice of the type of the surgical intervention allowed to reduce complications of acute hepatic insufficiency (3 patients or 1,15%) with one lethal outcome and to avoid pancreatonecrosis after the operation. Early diagnosis and timely surgical treatment of patients with cholelithiasis as well as special measures for the prevention of complications could result in less postoperative complications and lethality and better remote results of the surgery.
Asunto(s)
Procedimientos Quirúrgicos del Sistema Biliar , Complicaciones Posoperatorias/prevención & control , Adulto , Enfermedades de las Vías Biliares/cirugía , Colecistectomía , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pancreatitis/cirugía , Cuidados Posoperatorios/métodos , Cuidados Preoperatorios/métodosRESUMEN
On the grounds of the experience with the treatment of 786 consecutive cases of acute pancreatitis and its complications and on the grounds of the experimental findings obtained in 1077 animals the author makes her comments on the therapeutic tactics in acute pancreatitis and its complications and on the grounds of the experimental findings obtained in 1077 animals the author makes her comments on the therapeutic tactics in acute pancreatitis. It has been found that the treatment of all the cases should start from an early and widely planned conservative therapy, while emergent surgical interventions in acute pancreatitis are undesirable. The volume of early and delayed surgical interventions is discussed. The author's attitude towards bursa omentalis tamponade, omentopancreatopexy, dissection of the abdominal posterior layer over the pancreas and towards the resection of the pancreas, in the absence of suppuration, is negative.