FACTORS OF REHABILITATION PROGNOSIS IN THE DEVELOPMENT OF A PHYSICAL REHABILITATION PROGRAM FOR PATIENTS WITH ACUTE CALCULOUS CHOLECYSTITIS AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

The urgency of the problem. Acute calculous cholecystitis is one of the most common diseases faced by general surgeons. In recent decades, various prognostic factors have been identified and effective treatment methods have been described to improve outcomes in patients with this pathology (lower morbidity and mortality, shorter hospital stay, and minimal conversion from laparoscopic to open procedures).The purpose. To determine the factors of the rehabilitation prognosis as a prerequisite for the justification of the program of physical rehabilitation (physical therapy) for patients with acute calculous cholecystitis after laparoscopic cholecystectomy. Methods. Synthesis and analysis of scientific sources, retrospective analysis of 50 medical records of patients with GKH who were on inpatient treatment in the surgical department of the Ivano-Frankivsk Central City Clinical Hospital in 2018. Of them, 36 are women and 14 are men. The average age of patients in general was 57.32±2.03 years. Research results. 86% of patients in the surgical department with CKD have concomitant chronic non-infectious diseases, most of which are patients with various degrees of obesity – 36%. Cases of exacerbation of chronic pancreatitis and COPD occur most often in the early postoperative period. Representatives of both sexes are prone to cardiovascular diseases, diseases of the gastrointestinal tract, but there is a greater number of women with obesity and type II diabetes. Most men suffer from COPD. Conclusions. Important risk factors for mortality and complications for patients with HCG after LHC are: high comorbidity, advanced and senile age, delayed surgery, chronic obstructive pulmonary disease, dementia and the need for preoperative vasoactive amines, impaired liver function, low platelet levels, heart disease – of the vascular system, low or high levels of blood pressure, higher levels of C-reactive protein, blood nitrogen in urine, prothrombin time, bilirubin, alkaline phosphatase and the presence of gram-positive microorganisms cultured in bile or blood contribute to complications and progression of the disease. Consideration of the above complication factors must necessarily be a prerequisite for justifying a physical rehabilitation (physical therapy) program for patients with acute calculous cholecystitis after laparoscopic cholecystectomy.