METHOD laparoscopic cholecystectomy in patients with gangrenous CHOLECYSTITIS perivesical COMPLICATIONS

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine and can be applied for performing laparoscopic cholecystectomy in patients with perivesicular complications of gangrenous cholecystitis. Insufflation of nitrous oxide into abdominal cavity is performed through umbilical ring. Laparoscopy is carried out and revision of abdominal cavity organs is performed. If gallbladder is enlarged in length by more than 10 centimetres, puncture of gallbladder is preliminarily performed and its contents is evacuated. Within an hour isolation of gallbladder, verification of bladder duct, artery and elements of hepaduodenal ligament is started. In case of combination of considerable inflammatory infiltration, adhesion of surrounding tissues and impossibility to verify elements of hepatoduodenal ligament within 1 hour decision about conversion is made. If within 1 hour it was possible to identify bladder duct, artery and hepatoduodenal ligament, gallbladder is laparoscopically ablated with application of electric coagulation. Abdominal cavity is sanitised through widened right lateral laparoport with sodium hypochlorite solution and dried with gauze tissue. Installation of rubber-gauze and catching drainage with internal diameter not less than 5 millimetres is performed into subhepatic space.;EFFECT: method makes it possible to reduce risk of purulent-inflammatory complications.;1 ex