Year 2012 Vol. 20 No 1

GENERAL AND SPECIAL SURGERY

K.M. KURBONOV, F.I. MAKHMADOV, N.M. DAMINOVA

PROSPECTS OF MINIMALLY INVASIVE TECHNOLOGIES APPLICATION IN DIAGNOSTICS AND TREATMENT OF POSTOPERATIVE BILE PERITONITIS

Tajik State Medical University named after Abu Ali ibn Sino

Objectives. Improvement of diagnostics and treatment results of patients with the postoperative bile peritonitis by applying contemporary minimally invasive technologies.
Methods. The given investigation is based on results analysis of complex diagnostics and operative treatment of 60 patients with the postoperative bile peritonitis (PBP) developed after surgical interventions because of the liver diseases and cholelithiasis during the period 1993 to 2010. The age of patients varied from 29 to 64 years. In all cases endosurgical and minimally invasive technologies (n=49) to treat PBP were effectively used as well as combined endoscopic interventions (n=11). PBP developed after traditional (n=39) and video laparoscopic cholecystectomy (n=5) and also after hydatidectomy and atypical liver resection (n=16).
Results. Results analysis has shown that PBP develops due to various causes among which the central place belongs to the morphofunctional liver state as well as to the volume and character of surgical interventions, tactical and technical mistakes made during the postoperative period and during the operation. Application of a new technology including video laparoscopy permits not only to diagnose timely the postoperative bile peritonitis development, but in the number of cases it makes it possible to eliminate effectively the source of peritonitis and to carry out an adequate sanitation and drainage of the abdominal cavity.
Conclusions. Combined minimally invasive interventions at early stages of PBP development allows determining the localization as well as eliminating and correcting the cause of the complication development and thus saving patients from repeated complicated reconstructive-restoration surgeries.

Keywords: postoperative bile peritonitis, procalcitonin level of the blood serum, C-reactive protein content, video laparoscopy, combined endoscopic interventions
p. 36 – 41 of the original issue
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Address for correspondence:
734003, Respublika Tadzhikistan, g. Dushanbe, pr. Rudaki, d. 139, Tadzhikskii gosudarstvennyi meditsinskii universitet, kafedra khirurgicheskikh boleznei ¹ 1,
e-mail: fmahmadov@mail.ru,
Makhmadov Farrukh Isroilovich
Information about the authors:
Kurbonov K.M., Academician of AMS of the Republic of Tajikistan, Doctor of medical sciences, Professor, head of the chair of surgical diseases ¹ 1 of Tajik State Medical University named after Abu Àli Ibn Sino.
Makhmadov F.I. Doctor of medical sciences, Assistant of the chair of surgical diseases ¹ 1 of Tajik State Medical University named after Abu Àli Ibn Sino.
Daminova N.M. Candidate of medical sciences, Assistant of the chair of general surgery ¹ 1 of Tajik State Medical University named after Abu Ali Ibn Sino.
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