Iatrogenia as a cause of postcholecystectomy syndrome
- Authors: Sitnikov V.A.1, Ibragimova D.R.1, Kasimova N.R.1, Styazhkina S.N.1
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Affiliations:
- Izhevsk State Medical Academy
- Issue: Vol 37, No 2 (2020)
- Pages: 41-47
- Section: Original studies
- URL: https://journals.rcsi.science/PMJ/article/view/34256
- DOI: https://doi.org/10.17816/pmj37241-47
- ID: 34256
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Abstract
Objective. To analyze the most frequent diagnostic, tactical and technical errors of young doctors, leading to postcholecystectomy syndrome.
Materials and methods. The analysis was based on the clinical material of 87 patients from the Surgical Department of Regional Clinical Hospital №1 and City Clinical Hospital №2 of Izhevsk regarding reconstructive and restorative surgeries on the biliary tract for the last 40 years (1978–2018).
Results. The reasons, causing iatrogenic injuries of the bile ducts during cholecystectomy, are diagnostic, tactical, technical. Diagnostic errors are more often associated with inadequate diagnosis of cholelithiasis and cholecystitis (underestimation of history, complaints, clinical picture of the disease and its complications; failure or impossibility of FGDS; insufficient topical diagnosis while ultrasound investigation of the biliary tract and abdominal organs). Tactical errors in surgeries on the gallbladder include: overly expectant tactics, incorrect choice of surgical approach and method of anesthesia, lack of experience of the surgeon, inadequate revision of the biliary tract during surgery, refusal from surgical cholangiography and external drainage of the choledoch in case of doubtful patency of the bile duct. Technical reasons are specific features of the anatomy of the extrahepatic biliary tract, factors complicating the surgery, violation of surgical technique when performing an operation on the bile duct.
Conclusions. Correct and timely diagnosis of bile diseases as well as qualified technique of surgical intervention will minimize the development of post-cholecystectomy syndrome and other iatrogenic complications.
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##article.viewOnOriginalSite##About the authors
V. A. Sitnikov
Izhevsk State Medical Academy
Author for correspondence.
Email: Natasha.kasimova2012@mail.ru
V.A. – MD, PhD, Professor, Academician of the Academy of Laser Sciences, member of European Association of Intensive Therapy, member of International Association of Surgeons-Hepathologists, Honoured Physician of RF
Russian Federation, IzhevskD. R. Ibragimova
Izhevsk State Medical Academy
Email: Natasha.kasimova2012@mail.ru
Student
Russian Federation, IzhevskN. R. Kasimova
Izhevsk State Medical Academy
Email: Natasha.kasimova2012@mail.ru
студентка
Russian Federation, IzhevskS. N. Styazhkina
Izhevsk State Medical Academy
Email: Natasha.kasimova2012@mail.ru
MD, PhD, Honoured Worker of Public Healthcare of Ural Region, Honoured Worker of Higher School of RF
Russian Federation, IzhevskReferences
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