Muraviov F. Features of treatment of complicated forms of gallstone disease in patients with liver cirrhosis

The purpose of the work: to improve the results of treatment of patients with complicated forms of gallstone disease with accompanying cirrhosis of the liver by determining the main risk predictors of unsatisfactory treatment results, modifying the diagnostic and preventive algorithm and improving modern methods of treatment of this category of patients. For the first time, a diagnostic and treatment algorithm was developed, formed and highlighted for the surgical treatment of patients with complicated forms of gallstone disease against the background of liver cirrhosis. The effectiveness of the improved diagnostic and treatment program in patients with complicated forms gallstone disease against the background of liver cirrhosis has been scientifically substantiated and practically confirmed. New methods of laparoscopic interventions in patients with complicated forms of gallstone disease against the background of liver cirrhosis and ascites have been improved and implemented, based on the modification of known trocar insertion methods when performing laparoscopic cholecystectomy in patients with concomitant liver cirrhosis and ascites. A prognostic index of the effectiveness of laparoscopic cholecystectomy in patients with liver cirrhosis was developed and implemented. The proposed and updated diagnostic and treatment algorithm with the route of patients for complicated forms of gallstone disease against the background of liver cirrhosis has been introduced into medical practice. New methods were introduced, which were confirmed by state acts on the right of patent ownership of the work, and were put into practice in medical institutions in Zhytomyr, Vinnytsia, and Poltava. For the first time, approaches to rational antibacterial prophylaxis and prevention of thromboembolic complications were proposed and implemented in patients with accompanying cirrhosis of the liver, which significantly reduce the risk of complications. The work highlights and analyzes the principle of intolerance to carbokiperitoneum pressure in patients with cirrhosis of the liver.