RÉSUMÉ
OBJECTIVE: To study the possibilities of minimally invasive methods for removing intra-abdominal calculi after laparoscopic cholecystectomy. MATERIAL AND METHODS: There were 5 patients with abdominal abscesses associated with infected calculi after previous laparoscopic cholecystectomy at the Sklifosovsky Research Institute for Emergency Care between 2020 and 2023. Mean age of patients was 55±12 years. There were 3 (60%) women and 2 (40%) men. All patients underwent minimally invasive treatment. RESULTS: Four patients (80%) underwent percutaneous drainage of abscess with subsequent replacement by larger drains and removal of calculi with endoscopic assistance. Event-free period after cholecystectomy was 44±32 months. One patient developed subhepatic abscess in 72 months after laparoscopic cholecystectomy. This patient underwent transluminal removal of calculus through the duodenal wall. There was 1 calculus in 3 (60%) patients, 2 calculi in 1 (20%) patient and 3 calculi in 1 (20%) patient. CONCLUSION: The above-mentioned cases demonstrate successful minimally invasive interventions for symptomatic abdominal calculi after laparoscopic cholecystectomy. Minimally invasive treatment can reduce surgical aggression and accelerate rehabilitation.
Sujet(s)
Abcès abdominal , Cholécystectomie laparoscopique , Interventions chirurgicales mini-invasives , Humains , Mâle , Cholécystectomie laparoscopique/effets indésirables , Cholécystectomie laparoscopique/méthodes , Femelle , Adulte d'âge moyen , Interventions chirurgicales mini-invasives/méthodes , Interventions chirurgicales mini-invasives/effets indésirables , Abcès abdominal/étiologie , Abcès abdominal/chirurgie , Complications postopératoires/étiologie , Complications postopératoires/prévention et contrôle , Complications postopératoires/diagnostic , Complications postopératoires/thérapie , Drainage/méthodes , Sujet âgé , Adulte , Résultat thérapeutique , Calculs biliaires/chirurgieRÉSUMÉ
OBJECTIVE: To improve the outcomes in ICU patients with blunt abdominal trauma via enteral therapy by saline enteral solution. MATERIAL AND METHODS: A retrospective and prospective study included 24 patients (18 (75%) men and 6 (25%) women) with blunt abdominal trauma who underwent examination and treatment at the Sklifosovsky Research Institute for Emergency Care. Age of patients ranged from 38 to 81 years (mean 50.1±13.6). RESULTS: Enteral therapy was followed by normalization of serum lactate, alanine aminotransferase and aspartate aminotransferase after 3 days. There were significant differences in decrease of lactate dehydrogenase, alanine aminotransferase and C-reactive protein. In the control group, these parameters decreased only by the 10th day. CONCLUSION: Inclusion of saline enteral solution into the complex therapy contributes to earlier recovery of gastrointestinal function and prevents compartment syndrome. These aspects reduced the number of patients with multiple organ failure.