Surgical treatment of biliary pathology in patients: 13 years of experience

Slobodan Arandjelovic
2016 Praxis Medica  
Bilijarna patologija predstavlja danas jednu od najčešćih indikacija za hirurško lečenje u abdominalnj hirurgiji. Kalkuloza žučne kese je ozbiljno patološko stanja, koja svojom učestalošću, težinom kliničke slike i mogućim komplikacijama čine značajan procenat urgentnih stanja u medicini. Septične komplikacije predstavljaju najznačajniji faktor morbiditeta i mortaliteta u bilijarnoj hirurgiji. U odnosu na polnu strukturu M:Ž=160:519 1:3,2 23,6%:76,4% dominira ženski pol. Najveća incidenca
more » ... eća incidenca bilijarnih obolenja u ovom intervalu je 91(13,4%) 2006 godine i 75 (11,0%) 2010. Prosečna incidenca je 52 pacijenta po godini a najmanja 2002. godine, 6 (0,9%) pacijenata. Najmlađi operisani pacijent je bila osoba ženskog pola starosti 12 godina. Najstariji pacijent je bila osoba ženskog pola sa 82 god. Raspon 70 g. Prosečna starost ispitanika je 51 godina, sa dominacijom osoba ženskog pola 76,4%. Cholecystitis chronica je zastupljen u 423 (62,3%). Cholecystitis acuta 251 (37%). Cholelythiasis 666 98%. Acalculosis 13 (1,91%).Kalkuloza žučne kese bila je prisutna u 666 (98,1%) slučajeva. Solitarna kalkuloza 149 (22,4%), Multipla kalkuloza 517 (77,6%). Odsustvo holelitijaze u bilijarnim obolenjima je verifikovano u 13 (1,91%) pacijenata. Akalkulozni holecistit je verifikovan u 8 (1,18%) slučajeva. Struktura operativnog nalaza ukazuje da žučna kesa predstavlja dominantno mesto infekcijskih zbivanja u akutnoj patologiji ekstrahepatičnih žučnih vodova 436 (64,2%).Hydrops 47 (10,8%). Empyema 102 (23,4%). Akutne komplikacije vezane za propagaciju infekcije sa žučne kese put glavnog bilijarnog stabla i slobodne trbušne duplje registrovane su u 2 (0,46%). Abscessus subhepatis 11(2,52%).Choledocholythiasis 6 (1,38%). Cholangitis ac 17 (3,9%). Neo vesicae felleae 7 (1,03%). Od toga polypus vesicae felleae 2 (0,4%), Ca vesicae felleae 4 (0,59%). Tu hepatocholedoci 1 (1,15%). Meta in hepate 4 (0,59%). m:ž=2:2. Icterus 8(1,18%). Odnos m:ž=7:1. Incidenca baktibilije u je 67%. Mikrobiološkom analizom uzoraka identifikovano je deset bakterijskih vrsta. Ključne reči: Biliarna patologija, holelitiaza, holecisitis, icterus. Neo vesicae felleae. Cholecystectomia. SUMMARYI Biliary pathology represents today one of the most common indication for surgery in abdominalnj surgery. Calculosis gallbladder is a serious pathological condition, that their frequency, severity and possible complications constitute a significant percentage of medical emergencies. Septic complications are the most important factor of morbidity and mortality in biliary surgery. In relation to the gender structure of M: F=160: 519 1 3.2 23.6%: 76.4% is female domination. The highest incidence of biliary diseases in this interval is 91 (13.4%) in 2006, and 75 (11.0%) of 2010 average incidence of 52 patients per year. The lowest incidence was 2002 g 6 (0.9%) patients. The youngest patient was females aged 12 years. The oldest patient who underwent surgery were female, with a 82 yr. The range is 82-12=70g. The average age of the patients was 51 years, with dominant females 76.4%. Cholecystitis chronice is present in 423 (62.3%), cholecystitis acuta 251 (37%). Cholelythiasa 666 98%. Acalculosa 13 (1.91%). Calculosis gallbladder was present in 666 (98.1%) cases. OP: Solitary holelithiasis, 149 (22.4%), multiple holelithiasis 517 (77.6%). The absence of cholelithiasis in biliary diseases was verified in 13 (1.91%) patients. Holecistit empyema was verified in 8 (1.18%) cases. The structure of the surgical findings shows that gallbladder represents the dominant place of infectious processes in the acute pathology of extrahepatic bile ducts. 436 (64.2%). Hydrops 47 (10.8%). Empyema 102 (23.4%). Acute complications related to the spread of infection from the gallbladder put the main biliary tree and free abdominal cavity were registered in 2 (0.46%). Abscessus subhepatis 11 ENGLISH
doi:10.5937/pramed1601029a fatcat:euf6bj5lnbf5hfdajjtt4ua64a