The technique of simultaneous laparoscopic operations in the treatment of gallstone disease and hiatal hernia

Abstract

Annotation. Aim of work – to evaluate the quality of medical aid for the regular and simultaneous treatment of patients with gallstone disease in combination with a hiatal hernia. To evaluate the safety of simultaneous operations in the treatment of such patients. Determine advantages and disadvantages of both treatment strategies. Assess the ergonomics of laparoscopic surgery techniques. For sampling the database, statistic collected at the laparoscopic surgery unit of the Volynian Regional Clinical Hospital was used. The number of patients was 332. Patients were formed into two groups: the group of simultaneous laparoscopic treatment (laparoscopic cruroraphy with Toupet fundoplication and laparoscopic cholecystectomy with advanced surgery technique) – the first group of 126 people, and the group with only one operation (laparoscopic cruroraphy) was performed – the second group of 206 patients. The method that was chosen in first group (simultaneous laparoscopic treatment with advanced technique) allowed to prevent re-hospitalization, one more operation, and all associated risks (surgical, anesthesiologycal). Though the cost was a slight increased time of surgery (52 minutes versus 41), as well as a slightly increased the average hospital stay (3.25 days versus 3.1 days) comparing to a single surgery group. Complication rate didn`t increased significantly (5.5% in the first group versus 6.3% in the second group), with zero mortality in both groups. These data allow us to notice the safety and value of this treatment method and to continue its research and testing. The method can be linked to increasing the efficiency of medical care by reducing the number of hospitalizations, the total hospital stay, and reducing the overall cost of treatment, minimizing the cost of dealing with the complications.