DETERMINATION OF RISK FACTORS IN PERSONS AFTER CHOLECYSTECTOMY AT THE ACUTE PHASE OF REHABILITATION AS A PREREQUISITE FOR THE CREATION OF INDIVIDUAL REHABILITATION PROGRAMS
Abstract
Cholecystectomy is one of the most commonly performed surgical interventions. 10–15% of the adult population suffer from gallstone disease. Both each surgical intervention and laparoscopic cholecystectomy (LCС) have certain risks. The purpose of the article is to determine the risk factors in patients after cholecystectomy at the acute stage of rehabilitation as a prerequisite for the creation of individual rehabilitation programs. Methods of the study: Analysis and synthesis of scientific and methodological literature, analysis of the charts of patients of the surgical department who underwent LCC. The American Society of Anesthesiologists (ASA) physical status classification system is used worldwide to predict and assess surgical risk, which was created to offer postoperative clinicians a simple classification of the patient’s physiological status to help predict surgical risk. This system divides the physical status of individuals into 5 classes: from a healthy patient to a patient in an extremely serious condition. Among the patients with Chronic calculous cholecystitis, 10% of patients and 15% of patients with Acute calculous cholecystitis were without concomitant somatic pathology, while all others had concomitant diseases. Conclusions: high surgical risk is associated with people with significant functional limitations and the following factors poorly controlled hypertension or subcompensated diabetes mellitus, obesity (BMI ≥40), COPD, implanted pacemaker, active hepatitis, alcohol dependence or abuse, slight decrease in cardiac output fraction, chronic renal failure requiring regular scheduled hemodialysis, myocardial infarction, transient ischemic attack, stroke, coronary heart disease or stenting in history (more than 3 months). The factors of unfavorable recovery in patients after LCC at the acute stage of rehabilitation are old age, musculoskeletal disorders, high degree of postoperative pain, increased anxiety and depression, and all the above factors that are present in patients of ASA class II, III, IV and V. However, other risk factors and prognosis of recovery should be taken into account at the next stages of rehabilitation.
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