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