FEATURES OF LAPAROSCOPIC CHOLECYSTECTOMY IN SPECIAL GROUPS OF PATIENTS

Abstract

Currently, laparoscopic cholecystectomy is the gold standard in patients with symptomatic gallstone disease. About 90% of cholecystectomies are performed laparoscopically due to faster recovery, fewer complications, cost and cosmetic effect. In this study, we evaluated the features of laparoscopic cholecystectomy in general, as well as in obese patients, aged patients, and pregnant women. Carrying out LCE in the elderly, pregnant women and obese patients today does not cause big problems. The main thing is to take into account the characteristics of each patient. In the case of LCE in the elderly, careful preoperative preparation of the vascular, hemodynamic, and respiratory status should be carried out to prevent adverse events. And the optimal period for the safest laparoscopic surgery in pregnant women is the second trimester. It is also necessary to remember that proper preparation should be carried out in consultation with obstetricians and anesthesiologists. At the same time LCE can be performed safely and effectively in patients with even a high degree of obesity showing equally good results compared to patients with normal BMI. Laparoscopic cholecystectomy is safe in patients with Child-Pugh A cirrhosis and should be used with caution in patients with Child-Pugh B cirrhosis. For patients with Class C cirrhosis, laparoscopic surgery is not recommended