Gaidarzhi E. Diagnostic, Treatment and Prophilaxis of Cardiovascular Complication of Laparoscopic Cholecystectomy

The dissertation is devoted to the actual problem of diagnostics, treatment and prophilaxis of cardiovascular complications of laparoscopic cholecystectomy. The main objective of the research is improvement the results in treatment patients with calculous cholecystitis by rising of efficiency in diagnostic of accompanying cardiovascular pathology and working out of a complex of means for diagnostics, treatment and prevention of cardiovascular complications of laparoscopic cholecystectomy. On the basis of the analysis of risk factors in the development of cardiovascular complications of laparoscopic cholecystectomy the algorithm of inspection, surgical tactics and a performance technique of laparoscopic cholecystectomy have been improved. The differentiated approach to a method of cholecystectomy (laparoscopic cholecystectomy, minimal laparotomy aproach) depending on the taped risk factors, various combination of which are determined as compensated, subcompensated and sub-, decompensated type of a cardiovascular system functional condition has been developed. The processed complex of actions has allowed to raise authentically efficiency in diagnostics of an accompanying cardiovascular pathology with patients of the basic group in comparison with control by 10,6 % (P<0,05) and to lower frequency of cardiovascular complications of laparoscopic cholecystectomy to 9,2 % at chronic calculous cholecystitis and to 14,3 % at acute calculous cholecystitis, which by 2,4 and 2,7 times is less, than in control group - 22,1 % and 38,9 % accordingly, as well as to avoid lethal cases in the postoperative period.