Mohamed H. Ways to improve the treatment for acute cholecystitis in patients with high operational risk

The dissertation is devoted to study into blood gas composition, acid-base balance, and cardiac rhythm in patients with acute cholecystitis and a high degree of operational risk dependent upon conditions of the surgical intervention performance. It allowed principal causes for complication development to be revealed both during the operation and in the postoperative period as well as to find some ways of their efficacious elimination.In the experiment, a П-like laparolift was developed, its advantages and shortages were showed in comparison with a fusiform laparolift. Peculiar features of changes in the abdominal wall were studied in cases of using laparolifting constructions, which facilitated their implementation in clinical practice for performing laparoscopic holecystectomy in patients with a high risk for negative effect of strained carboxyperitoneum.A comparative analysis of the surgery results in patients with acute cholecystitis and a high operational risk revealed advantages of low-invasive laparoscopic technologies, especially with selective use of laparolifting constructions. The number of postoperative complications reduced by 11.4%, mortality rate lowered by 3.12%. In addition, conditions of the surgery performance improved and postoperative rehabilitation of patients was optimized