Babiy O. Miniinvasive cholecystolithotomy in treatment of single cholecystolithiasis

The thesis is devoted to improvement of results of surgical treatment of some patients with non-complicated course of single cholecystolithiasis (SCL) by elaboration and introduction of methods of organ-saving miniinvasive operations and prevention of gall stones recurrence. In the first time there was performed the complex studying of pathogenetic links of SCL genesis depending on motility function of gallbladder, state of bile formation and cholecystokinin (CCK) level of blood. There was established, that in patients with non-complicated SCL one of reasons of bile formation is bile lithogenity and gallbladder hypotony due to insufficient CCK level. There were substantiated pathogenetically the differential approaches to surgical treatment of gallstones disease, separately in patients with non-complicated SCL. There were elaborated and substantiated the new methods of miniinvasive cholecystolithotomy in patients with non-complicated SCL combined with postoperative correction of some links of pathogenesis of gallstones disease, their usage improves significantly the quality of life of patients after operation. That was proved that the functional digestive disorders after cholecystectomy were caused by change of CCK contents, basal CCK level after gallbladder excretion increased in 1,7 times (Р<0,01), stimulated CCK level - in 2,0 times (Р<0,01), whereas after cholecystolithotomy CCK level did not change evidently. The introduction of elaborated diagnostic criteria selection of patients and improved methods of surgical treatment enabled to decrease avoid the intraoperational complications, decrease the number of early postoperational complications from 4,6% to 2,5%, to avoid the postoperational lethality and development of functional digestive disorders that occurred in 22,8% cases after delete of gallbladder.