Kovalchuk O. Laparoscopic surgery of cholelithiasis in patients with chronic hepatitis and cirrhosis of the liver

In the dissertation there were presented results of the research in 401 patients with cholelithiasis, that had progressed on the background of chronic hepatitis or cirrhosis of the liver. It was established that the clinical course, results of biochemical, immunological, histological and tool studies in the patients with acute and chronic cholecystitis on the background of chronic hepatitis and cirrhosis of the liver, substantially differed from analogous indices in the patients without displays of mentioned diseases. There was worked out the scheme of pre-operative preparing of the sick, direcetd at the disoreders correction of homeostasis, basic life organism functions, blood-clotting sequence, portal hypertension. For the choice of methods and size of surgical interference there was worked out the diagnostic and remedial algorithm. There was imroved the technique of surgical interferences accomplishment on different stages of laparoscopic cholecystectomy in the sick with cholelithiasis, which progresses on the background of chronic hepatitis and cirrhosis of the liver taking into consideration anatomo-morphological changes in the liver parenchyma, gall bladder, hepatoduodenal ligament, local manifestations of portal hypertension. On purpose to prevent intra- and postoperative complications when performing cholecystectomy in the patients with chronic hepatitis and cirrhosis of the liver there were worked out and patented a number of methods and technical modes of surgical interference, that significantly allowed to reduce the risk of operation.