1.Laparoscopic cholecystectomy in surgical treatment of acute cholecystitis
Baasanjav N ; Batbold B, Bastuya ; Altangerel D ; Ganbaatar M ; Lochin TS ; Erdenebold D ; Gankhuyag G
Mongolian Medical Sciences 2015;171(1):13-15
BACKGROUND:Acute inflamed process in gallbladder stand no more in the list of contraindication for its laparoscopicremoval, although specifity of operational technics need to be elaborated in details.PURPOSE:The purpose of the study to determine feasibility and specifity of laparoscopic cholecystectomy.METHODS AND MATERIALS:Based on standard instructions three holes were punched on the front wall of the abdominal cavity forinsertion of fibroscopic instrument, Olympus-2008, Model-Uni 3, input-120/240V, 50/60Hz, 150VA. Patientselection included 108 individuals hospitalized during 2009-2013 in the department of urgent surgery, IIIShastin Clinical Hospital.RESULTS:Average ages of the patients were 38. Clinical diagnosis based on signs and symptoms revealed at thephysical examination confirmed by echosonographic investigation for final diagnosis. Specificity of surgicaltechnics were incision and infusion of large amount of antibiotic solution into the inflamed gallbladder at theinoculation; use blunt edge for inoculation of the duct and artery of gallbladder; switching to open surgeryin case of revealed massive enzymatic infiltration and adhesive scars.CONCLUSION: Laparoscopic cholecystoectomy is feasibility operative procedure having advantages anddisadvantages, requiring necessary preventive measures of the complications.
2.Planned endoscopic examination of the abdomen for pancreatic necrosis and advanced peritonitis
Lochin Ts ; Baasanjav N ; Byambakhuu B ; Erdenechimeg J
Mongolian Medical Sciences 2021;196(2):32-36
Introduction:
We classify peritonitis as end-stage if it lasts for more than 72 hours or more than three days. At this
point, the pleural effusion of the posterior abdominal wall, the pleural layer of the gastrointestinal
tract, and the dimples of the esophagus are all scattered with pus. During the first operation, it is very
difficult to completely cleanse these abscesses. After the operation, pus will collect in the abdomen
and abscesses will form, which will require another operation. If this postoperative complication is
not diagnosed in time and operated again (relaparotomy), many other complications can occur and
the risk of death is high. 48-hour relaparotomy mortality is higher than early surgery (21.8% -76.8%).
Necrotic pancreatitis is chronic peritonitis (an abscess of the lower extremities) in which only non-pancreatic adipose tissue, sebum glands, pericardial effusions, pericardial effusions, and kidney
adipose tissue become necrotic.
Purpose:
Endoscopic surveillance for chronic pleurisy with pancreatic necrosis
Objectives:
1. Endoscopic monitoring of the postoperative course of pancreatic necrosis.
2. Calculate the results of washing and cleaning using binoculars.
Method:
Patients with advanced peritoneal inflammation and necrotizing pancreatitis should be selected for
reoperation. After removing the dead pancreatic tissue (necrosectomy), all layers of the abdomen are
temporarily closed. A 6 mm short tube with surgical rubber is cut into the small pancreas, inserted 2
cm deep into the standard abdomen and sutured to the skin. Or use a silicone tube 4 - 5 cm long.
Result:
The study was carried out on 56 patients in 2016-2020. The mean age was 50 (89%) for men, 6 (11%)
for women, and 47.5 ± 8.6.
Conclusion
1. Endoscopic follow-up showed 19 (76%) persistent postoperative peritonitis and re-clearance,
and 6 (24%) patients were not diagnosed with persistent peritonitis.
2. 25 (50%) cases of persistent peritonitis after surgery were washed 1-3 times. This method has
proven to be a safe and easy procedure and can be used in any urban or rural hospital.