Cherkova N. Use of Ultrasound Effect in Case of Laparoscopic Cholecystectomy in Patients with Cholelithiasis (experimental clinical research).

Object of the study: Cholelithiasis. Purpose of the study: To improve the results of surgical treatment for cholelithiasis by means of substantiation of the use of ultrasound treatment for dissection and coagulation during LCE as a method of prevention of intraoperative and early postoperative complications. Methods of the investigation: Clinical, biochemical methods, parameters of lipid peroxidation, electron microscopy and histomorphology study of the liver bioptates. Instrumental methods included ultrasound study of the abdominal organs, fibrogastroduedenoscopy, videolaparoscopy. Practical significance of the obtained results: Practical recommendations on the use of ultrasound treatment in LCE in patients with CL are reported. Basing on the analysis of intraoperative and postoperative complications in patients with various forms of CL operated using LCE with the use of ultrasound and electrocoagulation treatment, the ways to reduce the incidence of complications and to prevent and treat them were determined. Novelty: For the first time, using ultrastructure and histo-morphology changes of the cellular structure of the liver, it was proven that the use of ultrasound treatment (UST) at cholecystectomy provides a careful dissection and tissue coagulation, stimulates reparative processes reaching a stable hemo- and cholestasis, allows to prevent coagulation necrosis in the zone of surgical intervention developing at electrocoagulation (EC). Experimental clinical investigation of LP at treatment with a monopolar electrode and ultrasound was performed. It allowed to reveal more pronounced inflammatory reaction in the liver tissue and blood serum at EC when compared with UST both at a tissue and organ level. The efficacy and safety of the use of ultrasound for dissection and coagulation of the tissues at LCE in patients with various forms of CL, which provides reduction of intra- and postoperative complications, was shown. A comparative analysis of the results of surgical treatment for CL operated using laparoscopy with electrocoagulation and ultrasound hemostasis is given. Degree of introduction: The findings of the research were introduced to the work of surgery departments of Railway Hospital (Kharkiv). Methodical recommendations "The use of physical methods in surgery" for doctors, interns and students were published. The findings of the research are used in the teaching process at surgery department of Kharkiv National University named after V.N. Karasin. Sphere of application: Medicine, surgery.