METABOLIC BASIS FOR REDUCTION OF SURGICAL AGGRESSION MANIFESTATIONS IN MINI-INVASIVE INTERVENTIONS

Aim. To assess the association of clinical effect of laparoscopic operations with reduction in endogenous intoxication and oxidative stress among patients with acute destructive cholecystitis complicated by acute pancreatitis. Materials and methods. The work is based on the materials of clinocolaboratory studies performed in patients with acute destructive cholecystitis complicated by acute pancreatitis. Clinicolaboratory studies were carried out in patients with acute destructive cholecystitis complicated by acute pancreatitis, who had undergone cholecystectomy using laparotomy ( n = 22) and laparoscopy ( n = 20). In group 1, progression of systemic membrane-destabilizing disorders and endotoxicosis in the early postoperative period was diagnosed. Results. When using mini-invasive laparoscopic techniques, less marked metabolic disorders were observed that is an important condition for prevention of acute pancreatitis progression. The correlation between the indices of free-radical lipoperoxidation, those of endogenous intoxication in patients after cholecystectomy fulfilled by different techniques and the basic postoperative clinicolaboratory indices including phospholipase and blood plasma alpha-amylase activity ( r = 0,763-0,934, p < 0,05) was stated. Conclusions. One of the most significant components of the best therapeutic effectiveness of low-traumatic surgeries is their ability to induce comparatively minor postoperative metabolic disorders.

Surgical aggression, cholecystectomy, mini-invasive interventions, metabolic disorders