Individualia tulžies latakų akmenligės rizika pagrįstas priešoperacinis ištyrimas ir tulžies latakų akmenligės gydymas prieš planuojamą laparoskopinę cholecistektomiją ; The Preoperative Prediction and Management of Choledocholithiasis before Planned Laparoscopic Cholecystectomy based on Individual Risk of Choledocholithiasis
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Medientyp:
E-Book
Titel:
Individualia tulžies latakų akmenligės rizika pagrįstas priešoperacinis ištyrimas ir tulžies latakų akmenligės gydymas prieš planuojamą laparoskopinę cholecistektomiją ; The Preoperative Prediction and Management of Choledocholithiasis before Planned Laparoscopic Cholecystectomy based on Individual Risk of Choledocholithiasis
Erschienen:
[Erscheinungsort nicht ermittelbar]: Institutional Repository of Vilnius University, 2021
Sprache:
Litauisch
Entstehung:
Hochschulschrift:
Dissertation, Institutional Repository of Vilnius University, 2021
Anmerkungen:
Beschreibung:
This paper reviews the history and management methods of choledocholithiasis, and compares different choledocholithiasis risk scales. The aim of the thesis was to optimise the choledocholithiasis risk prediction system before elective laparoscopic cholecystectomy and to determine which diagnostic tactic - preoperative endoscopic ultrasound or intraoperative cholangiography - is the most effective for patients with gallbladder stones and with intermediate risk of choledocholithiasis. Two clinical trials are presented. The retrospective study evaluates the original prognostic index used at Vilnius University Hospital Santaros Clinics, separate risk predictors and compares the two main tactics for the management of choledocholihiasis. Based on the findings from this study, new thresholds for choledocholithiasis risk are established, categorising patients into low, intermediate and high-risk groups. A prospective study was conducted for patients in the intermediate choledocholithiasis risk group to determine the best diagnostic and treatment strategy for this group. The impact of different risk factors on the diagnosis of choledocholithiasis and the characteristics of the two diagnostic tactics (endosonography and intraoperative cholangiography) were compared. The optimal algorithm and recommendations for the management of patients with possible choledocholithiasis are presented.