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Diagnostic-curative values of laparoscopy in cholecystitis and acute pancreatitis


Author: Ciutac Ion
Degree:doctor habilitat of medicine
Speciality: 14.00.27 - Surgery
Year:2012
Scientific consultant: Gheorghe Ghidirim
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific council: DH 50-14.00.27-27.03.08
Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 22 February, 2012
Approved by NCAA on the 5 April, 2012

Abstract

Adobe PDF document – 0.62 Mb / in romanian

Keywords

Laparoscopic cholecystolithostomy, acute cholecystitis (AC), destructive acute pancreatitis (DAP), obstructive acute pancreatitis, endoscopic papillosphincterotomy

Summary

,,Diagnostic-curative values of laparoscopy in cholecystitis and acute pancreatitis”, thesis for the Ph.D (in Medicine) degree, Chisinau 2012. The Work is exposed on 261 pages and includes an introduction, 6 chapters, a closing part with conclusions and practical recommendations, references (414 sources), 59 tables and 84 figures. The results obtained have been presented in 65 scientific papers. Key – words: Laparoscopic cholecystolithostomy, acute cholecystitis (AC), destructive acute pancreatitis (DAP), obstructive acute pancreatitis, endoscopic papillosphincterotomy. Field of research: Laparoscopic surgery. Purpose and objectives of the study: to improve the surgical treatment results in the risc group of pationts with AC and those with DAP using miniinvasive laparoscopic methods of treatment. Objectives of the work: to elaborate and to use the miniinvasive laparoscopic methods in the treatment of risk group patients with AC and DAP based on new technologies including priority elements as compared to the traditional surgical methods. The research methodology: A controlled clinical study comparing different methods of surgical AC and DAP treatments (miniinvasive laparascopic methods elaborated by the author vs the traditional surgical ones). Novelty and scentific originality: A complex and profound study of using laparoscopic cholecystolithostomy in assessing AC treatment results in the risk group patients and the positive impact of laparoscopic miniinvasive methods used early in the disease have been conducted. Theoretical importance: For the first time, different methods of laparoscopic cholecystolithostomy of staging the treatment have been worked out; the final step of the surgical treatment evaluating the immediate and follow-up results. The concept of obstructive acute cholecystitis causes and pathophysiology, as wel as of biliary hypertension, has been suggested. The elaborated miniinvasive laparoscopic methods were used early in panceronecrosis not only as a treatment but also as a preventive measure. A detalied study of laparoscopic semiology made possible the laparoscopic prognosis of pancreonecrosis. Practical value of the work: The elaborated miniinvasive methods as well as the theoretical postulates of the work permitted to perfect the medico-surgical strategy in AC and DAP patients. Their use reduces considerably the complications and mortality in the group of patients mentioned. Scientific results application: The basic principles of the conducted studies have been implemented in teaching students the course of endoscopy and miniinvasive surgery. The study results have been used in everyday practice at the Surgical Department of the National Scientifico-Practical Center of Emergency Medicine, Municipal Hospital No. 1, Central Clinical Railway Hospital and other hospitals in the RM.