Postcholecystectomy Syndrome – an Update of an "Old" Problem. Diagnosis and Modern Therapeutic Strategy // Постхолецистектомичен синдром - актуален поглед върху “стар“ проблем. Диагностика и съвременна терапевтична стратегия

Since the 1990s, laparoscopic cholecystectomy has replaced open cholecystectomy, and its frequency has increased, probably due to its relatively timely performance. Despite the large number of cholecystectomies performed worldwide, a 100% curative effect is not recorded in patients, as it is possible persistence of the same symptoms before surgery or the appearance of new symptoms after cholecystectomy. The invention of laparoscopic cholecystectomy by Muhe in 1986 quickly became the treatment of choice for symptomatic gallbladder disease. Minimally invasive procedures have revolutionised the treatment of patients with gallbladder disease and changed the profile of cholecystectomy. The cholecystectomy is considered a successful operation when complete relief of preoperative symptoms is achieved in more than 90% of patients. However, over 15–20% of cholecystectomy patients report various GIT complaints. The thesis aims to explore, analyse and apply in clinical practice modern diagnostic and therapeutic strategies and treatment methods in patients with PCS in order to optimise outcomes and reduce complications and mortality in operated patients. A retrospective analysis of 1532 patients with GBD and its complications for the period 2011 - 2022, operated in the Second Department of Abdominal Surgery of St. Marina Hospital Varna, was performed. The literature analysis has revealed that PCS has again become an actual problem, with the underlying cause being the wide application of laparoscopic cholecystectomy. The treatment results of patients with PCS over a ten-year period showed that an individualised approach should be sought and chosen for each specific patient, with the best results in the surgical treatment of PCS using external or internal biliary drainage. Bile duct injury (BDI) is a serious complication with an increasing incidence of great medical, social and economic importance. The surgical techniques we applied provide long-term adequate biliary drainage and are characterised by low perioperative morbidity and lethality. At the same time, they provide a good quality of life for operated patients. Internal biliary drainage is preferable to external biliary drainage. Endoscopic and minimally invasive procedures are applied early in the therapeutic process with subsequent surgical intervention if necessary. The treatment of PCS requires an individualised multidisciplinary approach and a team of interventional radiologists, endoscopists, gastroenterologists and surgeons in specialised hepatobiliary centres.

Grantor dc:publisher

Medical University of Varna

Year dc:date

2024

Authors dc:creator

• Bozhkov, Vasil
• Божков, Васил

• cholecystectomy
• gallbladder disease
• surgical treatment
• Хирургия / Surgery

Repository record dc:identifier

http://repository.mu-varna.bg/handle/nls/3569

OAI identifier oai:identifier

oai:repository.mu-varna.bg:nls/3569