Perioperative prevention of thrombohemorrhagic complications in patients with calculous cholecystitis and obstructive jaundice
The OBJECTIVE was to improve the effectiveness of prevention of thrombohemorrhagic disorders in patients with calculous cholecystitis and obstructive jaundice.METHODS AND MATERIALS. The clinic examined 537 patients operated on for obstructive jaundice. From 2010 to 2015, the prevention of thrombohem...
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| Format: | Article |
| Language: | Russian |
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Pavlov First Saint Petersburg State Medical University
2022-05-01
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| Series: | Вестник хирургии имени И.И. Грекова |
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| Online Access: | https://www.vestnik-grekova.ru/jour/article/view/1841 |
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| author | V. E. Fedorov B. S. Kharitonov A. D. Aslanov O. E. Logvina |
| author_facet | V. E. Fedorov B. S. Kharitonov A. D. Aslanov O. E. Logvina |
| author_sort | V. E. Fedorov |
| collection | DOAJ |
| description | The OBJECTIVE was to improve the effectiveness of prevention of thrombohemorrhagic disorders in patients with calculous cholecystitis and obstructive jaundice.METHODS AND MATERIALS. The clinic examined 537 patients operated on for obstructive jaundice. From 2010 to 2015, the prevention of thrombohemorrhagic complications consisted in the determination of risk factors, elastic compression of the lower extremities and the appointment of anticoagulants (1st comparative group). Since 2015, all medical measures have also been carried out taking into account the stages of obstructive jaundice (2nd study group).RESULTS. When comparing the results, the number of subhepatic abscessed hematomas decreased from 4 (1.6 %) patients in the first group to 2 (0.8 %) in the second, the number of gastric bleedings-from 6 (2.4 %) to 3 (1.2 %), metrorrhagia – from 3 (1.2 %) to 1 (0.4 %), pancreatic necrosis – from 8 (3.2 %) to 5 (1.9 %), pulmonary embolism – from 7 (2.8 %) to 5 (2.0 %), the number of strokes and transient disorders of cerebral circulation – from 5 (2.0 %) to 3 (1.2 %), the number of cardiac arrhythmias in the form of atrial fibrillation-from 3 (1.2 %) to 2 (0.8 %). The incidence of myocardial infarction decreased from 5 (2.0 %) patients to 3 (1.2 %), and the incidence of mesenteric vascular thrombosis decreased from 3 (1.2 %) to 1 (0.4 %). In group 1, 2 (0.8 %) patients had hemobilia.CONCLUSION. In addition to protocols and standards, the prevention of thrombohemorrhagic complications should take into account the stages of obstructive jaundice. During the period of cholestasis, the prevention of thrombohemorrhagic complications should be used in the same volume as in the absence of jaundice. In hepatocytolysis, it should be performed using the CHA2DS2-VASc scale with the HEMORR2HAGESscale as a safety net. In cholangitis, on the contrary, the main role is assigned to the HEMORR2HAGESscale. |
| first_indexed | 2024-04-10T02:18:29Z |
| format | Article |
| id | doaj.art-5f3f9b339424499d803bacffd549ec6b |
| institution | Directory Open Access Journal |
| issn | 0042-4625 |
| language | Russian |
| last_indexed | 2024-04-10T02:18:29Z |
| publishDate | 2022-05-01 |
| publisher | Pavlov First Saint Petersburg State Medical University |
| record_format | Article |
| series | Вестник хирургии имени И.И. Грекова |
| spelling | doaj.art-5f3f9b339424499d803bacffd549ec6b2023-03-13T08:09:21ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252022-05-011806344210.24884/0042-4625-2021-180-6-34-421345Perioperative prevention of thrombohemorrhagic complications in patients with calculous cholecystitis and obstructive jaundiceV. E. Fedorov0B. S. Kharitonov1A. D. Aslanov2O. E. Logvina3Saratov State Medical University named after V.I. RazumovskySaratov State Medical University named after V.I. RazumovskyKabardino-Balkarian State University named after H.M. BerbekovKabardino-Balkarian State University named after H.M. BerbekovThe OBJECTIVE was to improve the effectiveness of prevention of thrombohemorrhagic disorders in patients with calculous cholecystitis and obstructive jaundice.METHODS AND MATERIALS. The clinic examined 537 patients operated on for obstructive jaundice. From 2010 to 2015, the prevention of thrombohemorrhagic complications consisted in the determination of risk factors, elastic compression of the lower extremities and the appointment of anticoagulants (1st comparative group). Since 2015, all medical measures have also been carried out taking into account the stages of obstructive jaundice (2nd study group).RESULTS. When comparing the results, the number of subhepatic abscessed hematomas decreased from 4 (1.6 %) patients in the first group to 2 (0.8 %) in the second, the number of gastric bleedings-from 6 (2.4 %) to 3 (1.2 %), metrorrhagia – from 3 (1.2 %) to 1 (0.4 %), pancreatic necrosis – from 8 (3.2 %) to 5 (1.9 %), pulmonary embolism – from 7 (2.8 %) to 5 (2.0 %), the number of strokes and transient disorders of cerebral circulation – from 5 (2.0 %) to 3 (1.2 %), the number of cardiac arrhythmias in the form of atrial fibrillation-from 3 (1.2 %) to 2 (0.8 %). The incidence of myocardial infarction decreased from 5 (2.0 %) patients to 3 (1.2 %), and the incidence of mesenteric vascular thrombosis decreased from 3 (1.2 %) to 1 (0.4 %). In group 1, 2 (0.8 %) patients had hemobilia.CONCLUSION. In addition to protocols and standards, the prevention of thrombohemorrhagic complications should take into account the stages of obstructive jaundice. During the period of cholestasis, the prevention of thrombohemorrhagic complications should be used in the same volume as in the absence of jaundice. In hepatocytolysis, it should be performed using the CHA2DS2-VASc scale with the HEMORR2HAGESscale as a safety net. In cholangitis, on the contrary, the main role is assigned to the HEMORR2HAGESscale.https://www.vestnik-grekova.ru/jour/article/view/1841calculous cholecystitisobstructive jaundiceрerioperative preventionthrombohemorrhagic complicationsanticoagulant therapy |
| spellingShingle | V. E. Fedorov B. S. Kharitonov A. D. Aslanov O. E. Logvina Perioperative prevention of thrombohemorrhagic complications in patients with calculous cholecystitis and obstructive jaundice Вестник хирургии имени И.И. Грекова calculous cholecystitis obstructive jaundice рerioperative prevention thrombohemorrhagic complications anticoagulant therapy |
| title | Perioperative prevention of thrombohemorrhagic complications in patients with calculous cholecystitis and obstructive jaundice |
| title_full | Perioperative prevention of thrombohemorrhagic complications in patients with calculous cholecystitis and obstructive jaundice |
| title_fullStr | Perioperative prevention of thrombohemorrhagic complications in patients with calculous cholecystitis and obstructive jaundice |
| title_full_unstemmed | Perioperative prevention of thrombohemorrhagic complications in patients with calculous cholecystitis and obstructive jaundice |
| title_short | Perioperative prevention of thrombohemorrhagic complications in patients with calculous cholecystitis and obstructive jaundice |
| title_sort | perioperative prevention of thrombohemorrhagic complications in patients with calculous cholecystitis and obstructive jaundice |
| topic | calculous cholecystitis obstructive jaundice рerioperative prevention thrombohemorrhagic complications anticoagulant therapy |
| url | https://www.vestnik-grekova.ru/jour/article/view/1841 |
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