Videolaparoscopic Technologies for Acute Surgical Abdominal Pathology Complicated by an Abscess of the Abdominal Cavity

Abstract

Resume. The purpose of the study: to improve the results of treatment of acute surgical abdominal pathology complicated by an abscess of the abdominal cavity, through the introduction of video laparoscopic surgery. Material and methods. The results of surgical treatment of 20 patients with abdominal cavity abscess (ACA) as a result of acute surgical abdominal pathology, which underwent minimally traumatic video laparoscopic (VLS) technology, were analyzed, which accounted for 31.3 % of all ACB. Research results and their discussion. Up to 2 hours after hospitalization in the surgical clinic, 9 (45 %) patients with acute destructive appendicitis were operated on, on the 2nd-12th day - 11 (55 %) for ineffective conservative therapy (acute destructive stone cholecystitis, infected pancreonecrosis, appendicular abscess, cancer colon?). During VLS, ACA was confirmed in 6 (30 %) patients and established for the first time in 14 (70 %). Nosological forms of acute surgical abdominal surgical pathology were also diagnosed. In group A, in 13 (65 %) patients, VLS operations were prioritized (cholecystectomy — 5, appendectomy — 4, only dissection of an appendicular abscess — 1, right-sided hemicolectomy — 1). Conversion was required in 2 (15.4 %) patients (in addition, dissection of an abscess of the head of the pancreas — 1, right-sided hemicolectomy — 1). Relaparotomy was performed in 1 (7.7 %) patient. Group B consisted of 7 (35 %) patients who underwent conversion due to the impossibility of dividing a dense ACA (appendectomy — 5, cholecystecto-my — 1, dissection of multiple pancreatic abscesses-1). After surgery, complications occurred in 3 (42 %) patients (wound suppuration, peritoneal phlegmon, pneumonia). 1 (14 %) patient with pancreatogenic sepsis died. Conclusions. VLS established or confirmed ACA, its cause and other complications in all patients, optimized treatment. Minimally invasive video laparoscopic operations reduced the duration of the operation, stay in bed and in the clinic, complications, relaparotomy, and mortality.