Surgical Treatment Of Acute Calculous Cholecystitis In Patients With Type 2 Diabetes Mellitus
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 8, Pages 1296-1309
Abstract
Research objective: To conduct a comparative analysis of surgical intervention methods in patients with acute calculouscholecystitis associated with type 2 diabetes mellitus and determine the operation of choice.Materials and methods. The researchinvolved 423 patients with acute calculouscholecystitis aged from 18 to 95 who underwent surgical treatment in the Surgical Department of the City Clinical Hospital No.1 in Tashkent in the period from 2015 to 2019. 195 (46.1%) patients had type 2 diabetes mellitus (25.5%). There were 142 (33.8%) men and 281 (66.2%) women. Laboratory diagnostics included clinical blood analysis, biochemical blood test, determination of glucose, bilirubin, creatinine, blood amylase, ALT, AST, ALP, coagulogram, as well as determination of the blood group and Rh factor.Instrumental diagnostics included ultrasound examination in combination with Doppler. When distributing patients according to the disease severity, the classification of the Tokyo Agreement on acute cholecystitis was applied (Tokyo guidelines (2007, 2013).
Results and discussion. Surgical intervention for acute calculouscholecystitis in patients with type 2 diabetes mellitus in 195 patientsincludedLCE for 104 (53.3%) patients, oblique muscle-splitting mini approach in the right hypochondrium for 91 (46.7%) patients, and open conversion for 4 (3,8 %) patients. The use of the laparoscopic method in the treatment of acute calculouscholecystitis in patients with type 2 diabetes mellitus provided a statistically significant reduction in surgery timing and the degree of intraoperative blood loss. In addition, it also reduced the number of postoperative complications almost two times compared with the open method.
Conclusion. The comparative analysis of the treatment outcomes showed that the application of LCE in diabetic patients has a number of advantages over the open method. Laparoscopic cholecystectomy in patients with acute calculouscholecystitis associated with type 2 diabetes mellitus is the operation of choice.
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