LAPAROSCOPIC CORRECTION OF THE REFLUX-GASTRITIS IN PATIENTS WITH POST-CHOLECYSTECTOMY SYNDROME

Abstract

Aim. To improve the results of treatment of patients with the post-cholecystectomy syndrome. Materials and methods. The analyzed materials reflect the results of complex diagnostics and surgical correction of reflux gastritis in 42 patients with post-cholecystectomy syndrome treated in the city clinical hospital of emergency in Dushanbe for the period of 2016-2018. Patients were divided into two groups: primary (n = 18) and control (n = 24). The control group included patients that received only conservative treatment. Results. All patients under examination had a reflux-gastritis of various degrees. In three cases (16.7%) patients with hypokinetic disorders of duodenum motility had a surgical correction by laparoscopic novocaine blockade of the celiac plexus (chemical neurectomy). In 8 (44.4%) cases, patients with a high location of the jejunal nerve loop due to peritoneal process (n = 3) and expressed periduodenitis (n = 5) received video-laparoscopic dissection of the adhesions (Strong’s operation). In 2 (11.1%) cases, during hyperkinesia of the duodenum surgery was limited to traditional open surgery in a form of a «dashed» seromyotomy. 5 (27.8%) patients with subcompensated and decompensated duodenal patency disorder and arterio-mesenteric compression of the duodenum, received shunting and combined operations on the duodenum. Conclusions. In the case of reflux gastritis in patients with the post-cholecystectomy syndrome, minimally invasive correction is recommended. Conservative treatment temporarily relieves patients. According to the results of the study, the most radical method of reflux-gastritis treatment is a laparoscopic correction, which significantly reduces the incidence of postoperative complications.