Experience of using polymer clips in patients with acute calculous cholecystitis in combination with chronic viral hepatitis


  • M.A. Kashtalian
  • A.O. Kolotvіn
  • L.I. Kolotvina
  • A.A. Kvasnevskiy
Keywords: acute calculous cholecystitis, chronic viral hepatitis, polymer clips, “slipping” clips from the applier

Abstract

In the article, the authors summarize the materials presented in the scientific foreign and domestic literature and acquired their own experience in the use of polymer and metal clips in patients with acute calculous cholecystitis (GKH) in combination with chronic viral hepatitis (CWG). The aim of the work was to optimize the clipping of the cystic duct during laparoscopic cholecystectomy in patients with acute calculous cholecystitis and chronic viral hepatitis. In the period from 2015 to 2017, 822 patients with GCS performed laparoscopic cholecystectomy (LHE). Clinching of the bladder duct and the bladder artery was carried out with metal clips in 339 (41.2%) patients and polymer clips in the type “Hem-o-lock” in 483 (58.8%) patients. In the study group, 59 (7.1%) patients with CKD in combination with CKD were included, in which for clumping of the bladder duct and bladder artery in 17 (28.8%) cases metal clips were used and in 42 (71.2%) cases polymeric. “Slipping” of clips from the clipper among the patients, in whom clapping was done with metal clips, was in 58 (17.1%) patients without CKD, and in 5 (29.4%) patients with CKD with CWG. When clumping with polymer clips, “slipping” clips from the applier was in 17 (3.5%) patients without HV and in 1 (2.4%) patients with HVC. Thus, polymer clips of the Hem-o-lock type are designed for use with an appropriate clipper, which fully repeats the structure of the clip, the problem of “slipping” in patients with GCS during the clumping of the bladder duct and bladder arteries can minimize and prevent the occurrence of complications such as bile duct and bleeding.

References

1. Barvanyan, G. M. & Gluhih, A. A. (2010). Hirurgicheskoe lechenie yatrogennyh povrezhdenij vnepechenochnyh zhelchnyh protokov posle holecistektomii [Surgical treatment of iatrogenic lesions of the extrahepatic bile ducts after cholecystectomy]. Vestnik Nacionalnogo mediko-hirurgicheskogo centra im. N.I. Pirogova – Bulletin of the National Medical-Surgical Center N.I. Pirogov, 5 (3), 57–60.

2. Bystrov, S. A. & Zhukov, B. N. (2012). Hirurgicheskaya taktika pri zhelcheistechenii posle miniinvazivnoj holecistektomii [Surgical tactics for bile elimination after minimally invasive cholecystectomy]. Medicinskij almanah “Hirurgiya” – Medical Almanac “Surgery”, 20 (1), 90–93. Vzyato s https://cyberleninka.ru/article/n/hirurgicheskaya-taktika-pri-zhelcheistechenii-posle-miniinvazivnoy-holetsistektomii.

3. Zaharchuk, A. P. (2015). Prichiny intraoperacionnyh oslozhnenij i ih profilaktika pri laparoskopicheskoj holecistektomii [Causes of intraoperative complications and their prevention during laparoscopic cholecystectomy]. Harkivska hirurgichna shkola – Kharkiv School, 3 (72), 34–36. Vzyato s http://nbuv.gov.ua/UJRN/Khkhsh_2015_3_8.

4. Kovalchuk, O. L. (2010). Laparoskopichna khirurhiia zhovchokamianoi khvoroby u khvorykh na khronichni hepatyty i tsyroz pechinky [Laparoscopic surgery of cholelithiasis in patients with chronic hepatitis and cirrhosis of the liver]. (Dys. doktora med. nauk). Vinnytskyi natsionalnyi medychnyi universytet imeni M.I. Pyrohova, Vinnytsia.

5. Kurbanov, D. M., Rasulov, N. I. & Ashurov, A. S. (2014). Oslozhneniya laparoskopicheskoj holecistektomii [Complications of laparoscopic cholecystectomy]. Novosti hirurgii – Surgery News, 22 (3), 366–373. Vzyato s https://cyberleninka.ru/article/n/oslozhneniya-laparoskopicheskoy-holetsistektomii.

6. Tishenko, A. M., Bojko, V. V., Smachilo, R. M. & Mushenko, E. V. (2014). Oslozhneniya laparoskopicheskoj holecistektomii i ih hirurgicheskaya korrekciya. Khirurhiia Ukrainy – Surgery of Ukraine, 3, 44–49. Vzyato s http://nbuv.gov.ua/UJRN/KhU_2014_3_11.

7. Hlebnikova, Yu. A. (2013). Vosstanovitelnye i rekonstruktivne operacii pri yatrogennom povrezhdenii vnepechenochnyh zhelchnyh protokov [Reconstructive and reconstructive operations for iatrogenic damage to the extrahepatic bile ducts]. (Dis. kand. med. nauk). Sibirskij gosudarstvennyj medicinskij universitet, Tomsk – Siberian State Medical University, Tomsk.

8. Aarts, M.J.B. & Engels, L.G.J.B. (2006). Mirizzi’s syndrome. Neth. J. Med., 64 (7), 252–253.

9. Aminian, A. & Khorgami, Z. (2012). Hem-o-lok clip is safe in minimally invasive general surgery: a single center experience and review of data from Food and Drug Administration. J. Minim. Invas. Surg. Sci., 1 (2), 52–57. DOI: 10.5812/jmiss.1885.

10. Brescia, A., Gasparrini, M., Nigri, G., Cosenza, U. M., Dall'Oglio, A., Pancaldi, A., Vitale, V. & Mari, F. S. (2013). Laparoscopic cholecystectomy in day surgery: feasibility and out comesof the first 400 patients. Surgeon, 11, 514–518. doi: 10.1016/j.surge.2012.09.006.

11. Kim, K. & Kim, T. (2014). Endoscopic management of Bile Leakage after Cholecystectomy: A single-Center Experience for 12 years. Clin. Endosc., 47 (3), 248–253. doi: [10.5946/ce.2014.47.3.248].

12. Nikolopoulos I., Ghananandan, J. & Kerwat, R. Hem-o-lok Clip–Related Complications After Colorectal Surgery. CRSLS MIS Case Reports from SLS.org2014. P. 1–4. DOI: 10.4293/JSLS.2014.00022.

13. Yahui, L., Bai, J., Yingchao, W. & Guangyi, W. (2012). Hem-o-lok clip found in common bile duct after laparoscopic cholecystectomy and common bile duct exploration: a clinical analysis of 8 cases. International Journal of Medical Sciences, 9 (3), 225–227. doi:[10.7150/ijms.4023].

14. Zhi-Bing Ou, Sheng-Wei Li, Chang-An Liu, Bing Tu, Chuan-Xin Wu, Xiong Ding … Jian-Ping Gong. (2009). Prevention of common bile duct injury during lapa-roscopic cholecystectomy. Hepatobiliary Pancreat Dis Int., 8 (4), 414−17.
Published
2018-09-28
How to Cite
Kashtalian, M., KolotvіnA., Kolotvina, L., & Kvasnevskiy, A. (2018). Experience of using polymer clips in patients with acute calculous cholecystitis in combination with chronic viral hepatitis. Reports of Vinnytsia National Medical University, 22(3), 485-488. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2018-22(3)-18