THROMBOEMBOLIC COMPLICATIONS IN PATIENTS WITH ACUTE CALCULOUS CHOLECYSTITIS

Abstract

The aim is the analysis of clinical and anamnestic, biochemical and hemostasiological parameters in thromboembolic complications in patients with acute calculous cholecystitis (ACC). Materials and Methods. A retrospective analysis of clinical information was performed regarding 206 patients with a diagnosis of acute calculous cholecystitis, who were hospitalized in the Emergency Medical Care Hospital of Lviv (current name: St. Panteleimon Hospital of the First Territorial Medical Association of the City of Lviv) in the period from 2014 to 2018. Results and Discussion. It was established that 2.91% of patients with ACC had thromboembolic complications, which were manifested in the form of deep vein thrombosis and PE of small branches and were more often diagnosed in patients with significantly older age (on average, 72.67±11.13 years of age). Thromboembolic complications in patients with ACC developed reliably more often in people who had concomitant pathology (hypertensive disease, IHD, COPD, liver cirrhosis, stroke). Patients with a complicated thrombotic diagnosis were also diagnosed with final non-thrombotic complications: local and general peritonitis, perivesical abscess, perforation, abdominal sepsis and subhepatic abscess. The average duration of laparoscopic cholecystectomy (LCE) in patients without complications was 60.00 [45.0-70.0] minutes, in patients with non-thrombotic complications - 62.50 [38.5-85.0] minutes, and in patients with thrombotic complications it was significantly longer - 95.0 [95.0-95.0] minutes (p<0.05). Conclusions. In patients with complicated acute cholecystitis, thromboembolic complications with local and general peritonitis, perivesical abscess were diagnosed more often (p<0.05). Patients with complicated acute calculous cholecystitis underwent cholecystectomy (83.33% [46.48-99.96]) reliably more often than patients with uncomplicated acute cholecystitis, whereas LCE was performed only in 16.67% [0.04-53.52] of cases. Therefore, cholecystectomy lasted for more than 1 hour in 80% [38,45-99,94] of cases.