Fira D. The prophylaxis of thromboembolic complications when performing laparoscopic cholesystectomies against a background of the pathology of the veins of lower extremities

The research presents results of the study of the state of blood coagulation system, the endogenous intoxication of a body, the processes of free radical oxidation and the index of endothelial dysfunction of vessels when performing laparoscopic cholesystectomies in patients with chronic calculous cholecystitis in combination with the pathology of veins of lower extremities. It was established, that in patients with the cholelithiasis in the postoperative period the risk of development of thromboembolic complications increases. In order to prevent thrombotic complications, the usage of the low molecular weight heparins in pre- and postoperative periods as for the patients with the pathology of the veins of lower extremities, as for the patients with the chronic cholecystitis was proposed. The algorithm of implementation of surgical interventions depending on a risk of thromboembolic complications was developed. For a high risk group before laparoscopic cholecystectomy the performance of crossectomy and the injection of the low molecular weight heparins 0,4 ml during 10 days is recommended. The algorithm of the period of the performance of simultaneous operational interventions on the veins of lower extremities and the criteria of the necessity of the usage of physical and pharmacological means for the prevention of thromboembolic complications is recommended.