[SIMULTANT OPERATIONS FOR BILIARY CALCULOUS DISEASE AS A METHOD OF PREVENTION OF POSTCHOLECYSTECTOMY SYNDROME].

Abstract Own experience of treatment of patients for biliary calculous disease, coexistent with other abdominal and retroperitoneal organs diseases, was analyzed. The rate of postcholecystectomy syndrome (PCHES) occurrence in such patients was determined, the impact of simultant operative interventions using laparoscopic and laparotomic accesses on the rate of the PCHES occurrence was established. The elaborated diagnostic-treatment algorithm with application of measures, directed on the PCHES prophylaxis, was elaborated. There was established, that performance of simultant operations in accordance to strict indications secures a trustworthy reduction of the PCHES occurrence rate.

[The early postoperative rehabilitation of the patients presenting with cholelithiasis and experiencing psychoemotional stress].

Early postoperative rehabilitation of the patients presenting with cholelithiasis and experiencing psychoemotional stress is designed to restore the function of bile secretion, enhance their adaptive capabilities, and normalize the psychovegetative status for the purpose of preventing further progress of the disease and reducing the risk of the development of post-cholecystectomy syndrome. The inclusion of drinking mineral water, magnetic laser therapy, and UHF therapy in the combined rehabilitative treatment of such patients results in the appreciable enhancement of all functional abilities of the body manifest as the significant improvement and normalization of clinical and laboratory characteristics (elimination of clinical symptoms of the disease, improvement of general and biochemycal parameters of peripheral blood). Simultaneously, the adaptive capabilities and the psychovegetative status of the patients improved as apparent from the increased lymphocyte count, normalization of the Kerdo and Hildebrandt indices and indices of stress level, decreased psychoemotional stress, enhancement of physical functioning characteristics. Taken together, these changes account for the high effectiveness of the above procedures of early postoperative rehabilitation of the patients presenting with cholelithiasisand experiencing psychoemotional stress (94.7%).

[The results of different types of cholecystectomy in elderly patients].

Treatment results of 1048 elderly patients, operated on the cholelithiasis, were analyzed. The group of minilaparotomic access cholecystectomy numbered 488 (46,6%) patients; the second group consisted of 560 (53,4%) patients, who had the traditional operation. All patients were operated on in a single hospital during 1998-2008 yy. The cholecystectomy from minilaparotomic access proved to be less traumatic and preferable for elderly patients. The rate of postoperative morbidity was 5,7%, mortality - 0,2%. The procedure, though, is subjected to the experienced surgeons.

Relation of coffee, green tea, and caffeine intake to gallstone disease in middle-aged Japanese men.

A possible protective effect of coffee or caffeine intake in the formation of gallstones has been suggested in some epidemiological studies. We examined the relation of coffee, green tea, and caffeine intake to gallstone disease in middle-aged Japanese men, distinguishing known gallstones from unknown diagnosed gallstones. Study subjects were 174 cases of gallstones as determined by ultrasonography, 104 cases of postcholecystectomy, and 6889 controls of normal gallbladder in the total of 7637 men who received a health examination at four hospitals of the Self-Defense Forces (SDF). Of the 174 cases of prevalent gallstones, 50 had been aware of having gallstones. Previously diagnosed gallstones and postcholecystectomy were combined as known gallstone disease. The consumption of coffee and green tea was ascertained by a self-administered questionnaire, and caffeine intake was estimated. Statistical adjustment was done for body mass index, smoking, alcohol use, rank in the SDF, and hospital. Coffee and caffeine intake were associated each with a statistically significant increase in the prevalence odds of known gallstone disease, but unrelated to newly diagnosed gallstones. Adjusted odds ratios of known gallstone disease were 1.7 (95% confidence interval [CI] 1.1-2.8) for coffee consumption of five cups or more per day vs. no consumption and 2.2 (95% CI: 1.3-3.7) for caffeine intake of 300 mg/day or more vs. less than 100 mg/day. The consumption of green-tea showed no material association with either unknown gallstones or known gallstone disease. The findings do not support a hypothesis that coffee drinking may be protective against gallstone formation.

[The postcholecystectomy syndrome and its prevention]. / Postkholetsistéktomicheskii sindrom i ego profilaktika.

61 patients had a surgery because of postcholecystectomy syndrome (PCS). In 29 patients PCS was caused by bile tract diseases, in 15 patients--liver and pancreas diseases, in 12 cases disease of other organs. There was no mortality in restorative operations. The mortality rate in reconstructive operations was 5%. The full clinical and instrumental examination of extrahepatic bile ducts is the best way to prevent PCS. PCS was most frequently observed in patients, operated on urgently. The results of 79 cases of reconstructive and restorative operations in patients operated on urgently are analysed.