[Characteristics of hemodynamic reactions during various endoscopic surgeries for cholelithiasis in patients with concurrent cardiovascular pathologies].
A prospective study of 170 patients with concurrent cardiac pathology, who had underwent the laparoscopic cholecystectomy under the conditions of a tense carboxyperitomium, led to isolating two groups of patients with high-risk of intra- and postoperative unfavorable cardiac-vascular responses: an original high risk degree (III-IV classes according to ASA), a high value of cardiac risk indices according to Goldman (III-IV classes) and according to Detsky (II-III classes), a hypodynamic blood circulation regimen under rest conditions, and ejection fraction (according to echocardiography) amounting below 50%. Such patients are recommended to be operated on by laparolifting or by low-gas laparoscopy with a local lifting, i.e. by using the surgical techniques free of any negative effects produced on the carboxyperitomium hemodynamics, while all positive features of small-invasion surgery remain intact.
Andreenko
A A
AA
Polushin
Iu S
IuS
Pereloma
V I
VI
Shirokov
D M
DM
Singaevskiĭ
S B
SB
Prishvin
A P
AP
D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004452:Echocardiography; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D016343:Monitoring, Intraoperative