ALGORITHM OF DIAGNOSTICS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS, CHOLEDOCHOLITHIASIS AND OBSTRUCTIVE JAUNDICE
We performed a retrospective analysis of treatment in 4,197 patients with acute cholecystitis. Destructive complicated cholecystitis was diagnosed in 658 (25.3%) patients . There were 431 (65.5%) patients of elderly and senile age. All patients had comorbidities. Cardiovascular insufficiency — 73.9%...
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| Language: | Russian |
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Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department
2017-06-01
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| Series: | Неотложная медицинская помощь |
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| Online Access: | https://www.jnmp.ru/jour/article/view/363 |
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| author | M. D. Dibirov G. S. Rybakov V. L. Domarev M. A. Vasilyeva B. M. Brodetsky M. V. Kosachenko |
| author_facet | M. D. Dibirov G. S. Rybakov V. L. Domarev M. A. Vasilyeva B. M. Brodetsky M. V. Kosachenko |
| author_sort | M. D. Dibirov |
| collection | DOAJ |
| description | We performed a retrospective analysis of treatment in 4,197 patients with acute cholecystitis. Destructive complicated cholecystitis was diagnosed in 658 (25.3%) patients . There were 431 (65.5%) patients of elderly and senile age. All patients had comorbidities. Cardiovascular insufficiency — 73.9%, respiratory diseases — 29.2%, diabetes — 26%. For urgent indications, 12 (2.8%) patients were operated, 2 (16.6%) of them died. In 419 (97.2%) patients, mini-invasive treatment was performed. Endoscopically, jaundice wasn’t managed in 86 (20.5%) cases. In 62 (14.8%) cases, percutaneous transhepatic microcholangiography was performed under ultrasound guidance. Laparoscopic cholecystectomy was performed in 183 (43.6 %) cases, traditional cholecystectomy was performed in 149 (35.6%) cases, and in 38 of them (23.9%) it was combined with Kerr’s drainage of choledoch. Mini-invasive cholecystectomy was performed in 87 (20.7%) cases. Postoperative complications were revealed in 21 (5.0%) patients, in 7 (2.9%) of elderly age and 14 (7.9%) of senile age. Postoperative mortality rate was 2.0%. The use of minimally invasive interventions in the complex treatment of this group of patients was the main goal and it was reasoned by the severity of the initial condition of elderly and senile patients. |
| first_indexed | 2024-03-12T18:14:01Z |
| format | Article |
| id | doaj.art-0dddfc612e2c4193a9429883152ec4cc |
| institution | Directory Open Access Journal |
| issn | 2223-9022 2541-8017 |
| language | Russian |
| last_indexed | 2025-03-14T10:25:13Z |
| publishDate | 2017-06-01 |
| publisher | Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department |
| record_format | Article |
| series | Неотложная медицинская помощь |
| spelling | doaj.art-0dddfc612e2c4193a9429883152ec4cc2025-03-02T11:06:18ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172017-06-016214514810.23934/2223-9022-2017-6-2-145-148353ALGORITHM OF DIAGNOSTICS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS, CHOLEDOCHOLITHIASIS AND OBSTRUCTIVE JAUNDICEM. D. Dibirov0G. S. Rybakov1V. L. Domarev2M. A. Vasilyeva3B. M. Brodetsky4M. V. Kosachenko5Moscow State University of Medicine and Dentistry named after A.I. Yevdokimov of the Ministry of Health of Russia; City Clinical Hospital n.a. S.I. SpasokukotskyMoscow State University of Medicine and Dentistry named after A.I. Yevdokimov of the Ministry of Health of Russia; City Clinical Hospital n.a. S.I. SpasokukotskyMoscow State University of Medicine and Dentistry named after A.I. Yevdokimov of the Ministry of Health of Russia; City Clinical Hospital n.a. S.I. SpasokukotskyMoscow State University of Medicine and Dentistry named after A.I. Yevdokimov of the Ministry of Health of Russia; City Clinical Hospital n.a. S.I. SpasokukotskyMoscow State University of Medicine and Dentistry named after A.I. Yevdokimov of the Ministry of Health of Russia; City Clinical Hospital n.a. S.I. SpasokukotskyMoscow State University of Medicine and Dentistry named after A.I. Yevdokimov of the Ministry of Health of Russia; City Clinical Hospital n.a. S.I. SpasokukotskyWe performed a retrospective analysis of treatment in 4,197 patients with acute cholecystitis. Destructive complicated cholecystitis was diagnosed in 658 (25.3%) patients . There were 431 (65.5%) patients of elderly and senile age. All patients had comorbidities. Cardiovascular insufficiency — 73.9%, respiratory diseases — 29.2%, diabetes — 26%. For urgent indications, 12 (2.8%) patients were operated, 2 (16.6%) of them died. In 419 (97.2%) patients, mini-invasive treatment was performed. Endoscopically, jaundice wasn’t managed in 86 (20.5%) cases. In 62 (14.8%) cases, percutaneous transhepatic microcholangiography was performed under ultrasound guidance. Laparoscopic cholecystectomy was performed in 183 (43.6 %) cases, traditional cholecystectomy was performed in 149 (35.6%) cases, and in 38 of them (23.9%) it was combined with Kerr’s drainage of choledoch. Mini-invasive cholecystectomy was performed in 87 (20.7%) cases. Postoperative complications were revealed in 21 (5.0%) patients, in 7 (2.9%) of elderly age and 14 (7.9%) of senile age. Postoperative mortality rate was 2.0%. The use of minimally invasive interventions in the complex treatment of this group of patients was the main goal and it was reasoned by the severity of the initial condition of elderly and senile patients.https://www.jnmp.ru/jour/article/view/363acute cholecystitisobstructive jaundiceminimally invasive surgerypercutaneous transhepatic microcholangiographyendoscopic retrograde cholangiopancreatographyelderly and senile agecomorbidity |
| spellingShingle | M. D. Dibirov G. S. Rybakov V. L. Domarev M. A. Vasilyeva B. M. Brodetsky M. V. Kosachenko ALGORITHM OF DIAGNOSTICS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS, CHOLEDOCHOLITHIASIS AND OBSTRUCTIVE JAUNDICE Неотложная медицинская помощь acute cholecystitis obstructive jaundice minimally invasive surgery percutaneous transhepatic microcholangiography endoscopic retrograde cholangiopancreatography elderly and senile age comorbidity |
| title | ALGORITHM OF DIAGNOSTICS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS, CHOLEDOCHOLITHIASIS AND OBSTRUCTIVE JAUNDICE |
| title_full | ALGORITHM OF DIAGNOSTICS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS, CHOLEDOCHOLITHIASIS AND OBSTRUCTIVE JAUNDICE |
| title_fullStr | ALGORITHM OF DIAGNOSTICS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS, CHOLEDOCHOLITHIASIS AND OBSTRUCTIVE JAUNDICE |
| title_full_unstemmed | ALGORITHM OF DIAGNOSTICS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS, CHOLEDOCHOLITHIASIS AND OBSTRUCTIVE JAUNDICE |
| title_short | ALGORITHM OF DIAGNOSTICS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS, CHOLEDOCHOLITHIASIS AND OBSTRUCTIVE JAUNDICE |
| title_sort | algorithm of diagnostics and treatment of elderly and senile patients with acute cholecystitis choledocholithiasis and obstructive jaundice |
| topic | acute cholecystitis obstructive jaundice minimally invasive surgery percutaneous transhepatic microcholangiography endoscopic retrograde cholangiopancreatography elderly and senile age comorbidity |
| url | https://www.jnmp.ru/jour/article/view/363 |
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