MODERN ASPECTS OF DIAGNOSTIC AND SURGICAL TREATMENT OF PATIENTS WITH GALLSTONE DISEASE AND HIATAL HERNIA COMORBID COURSE

Abstract

Summary. Introduction. As of today, the issue of timely diagnosis and surgical treatment of gallstone disease (GD) and hiatal hernia (HH) comorbid course is extremely relevant and in need of attention. Aim. Improvement of diagnosis and surgical treatment of patients with GD and HH comorbid course by performing simultaneous laparoscopic surgery. Materials and methods. The main group consisted 16 patients, who were treated for the comorbid course of GD and HH by performing simultaneous laparoscopic surgery. The comparison group was made of 15 patients with similar pathologies with laparoscopic surgical treatment during two patients visits to the hospital. The study was carried out on the basis of the GI «V. T. Zaitsev IGЕS NAMSU». Results of the research. The average duration of simultaneous laparoscopic surgery in the main group of patients was ((87.5±17.5) min, p<0.05) and was significantly lower than in the comparison group – ((101.2±9.3) min, p<0, 05). The total volume of blood loss was (45.5±11.1 ml, p<0,01) in the main group of patients, while in the comparison group — ((79.1±5.7) ml, p<0,01). The average intensity of the pain syndrome (according to the McGill pain questionnaire) in the postoperative period in the main group of patients was ((3.1±0.8) points, p<0.01), and in the comparison group – ((7.9±0.7) points, p<0.01). The total duration of preoperative examination of patients in the main group was ((1.33±0.5) days, p<0.05) and in the comparison group — ((3.22±0.65) days, p<0.05). The average total number of temporary incapacity of workdays in the main group did not exceed ((5.5±1.1) days, p<0.05), while in the comparison group — ((11.2±0.6) days, p<0,05). Conclusions. It has been proven that simultaneous laparoscopic surgical intervention is the method of choice for treating patients with GD and HH comorbid course. In addition, the results of the study demonstrate the importance of careful diagnosis of patients for the presence of GD and HH comorbid course, considering of high probability of their combination.