Intra-abdominal purulent-septic complications of the hepatobiliary zone, adequate choice of correction method

Objective. To determine an adequate choice of correction method in patients with postoperative intra-abdominal purulent-septic complications of hepatobiliary zone pathologies.

 Material and methods. The study involved 142 patients who had intra-abdominal purulent-septic complications that required repeated corrective interventions after liver and biliary system surgeries. Retro- and prospective studies were conducted at the Department of Surgical Diseases No. 1 named after Academician K. M. Kurbonov of the State Educational Institution “Tajik State Medical University named after Abuali ibni Sino” and the State Institution “Institute of Gastroenterology of the Republic of Tajikistan” for the period 19972022. All patients with postoperative intra-abdominal purulent-septic complications (PIBPS) were divided into two groups. In the control group of patients, including 52 (36.6%) patients (retrospective study), PIBPS correction was performed using standard methods of traditional surgery. In 90 (63.4%) patients of the main group, minimally invasive methods of PIBPS correction were used.

 Results. Of the 142 patients with PIBPS, 63.4% (n=90) of the patients in the main group underwent repeated minimally invasive interventions in 88.9% (n=80) cases, and only in 10 or 11.1% of cases, complications were corrected by relaparotomy. In 33 (23.2%) cases of patients in the control group (n=52), relaparotomy was performed, and in 19 (13.4%) cases - extraperitoneal opening and drainage of postoperative intra-abdominal abscess. During the treatment of 142 patients, 43 (30.3%) of them, including 10 from the main group and 33 from the control group, were found to have postoperative complications in the form of purulent-septic complications, for which they underwent relaparotomy. Patients with postoperative peritonitis in the main (n=31) and control groups (n=23) underwent 27 (87.1%) minimally invasive interventions and relaparotomy (12.9%). Whereas, patients in the control group underwent relaparotomy in all 23 observations.

 Conclusion. Pathogenetically based correction of complications using modern technologies allows to significantly improve the immediate results of treatment of patients after operations on the liver and biliary system.

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