scholarly journals The choice of surgical treatment method of patients with bacterial liver abscesses

2012 ◽  
Vol 93 (2) ◽  
pp. 265-269 ◽  
Author(s):  
A P Tolstikov
Keyword(s):  
Postoperative Complications ◽  
Ultrasound Guidance ◽  
Comparison Group ◽  
Average Duration ◽  
Abdominal Cavity ◽  
Bile Leakage ◽  
Main Group ◽  
Early Postoperative Complications ◽  
Liver Abscesses ◽  
Bed Days

Aim. To improve the results of surgical treatment of patients with bacterial abscesses of the liver. Methods. During the period from 2000 to 2010 treated were 118 patients with bacterial liver abscesses, 75 men and 43 women aged from 18 to 80 years (mean age 52.1 years). Management of the patients was based on the developed algorithm of diagnosis and treatment of liver abscesses. Two groups of patients were formed: the main group (treatment consisted of percutaneous puncture and drainage of the abscesses under ultrasound guidance) - 94 patients, the comparison group - 24 patients. In the comparison group surgical interventions were performed using the transabdominal access: laparotomy, opening and drainage of the abscess (18 patients), hepatic resection (3 patients), left-sided hemihepatectomy (2 patients), right-sided hemihepatectomy (1 patient). Results. In the patients of the comparison group the following early postoperative complications developed: wound infection - 4, intra-abdominal hemorrhage - 1, bile leakage - 1, abscesses of the abdominal cavity - 2, exudative pleuritis - 2, pneumonia - 3 cases. The average duration of patient hospitalization was 19.5±1.6 bed-days. In the main group the average duration of patient hospitalization was 9.2±±0.6 bed-days. Early postoperative complications in patients of the main group included: intra-abdominal hemorrhage - 1, bile leakage - 1, abscesses of the abdominal cavity - 1, exudative pleuritis - 2, pneumonia - 2 cases. There were no deaths in either of the groups. Conclusion. Puncture and drainage of bacterial liver abscesses under ultrasound guidance is an effective method of treatment that makes it possible to reduce the number of abdominal operations, reduce the number of postoperative complications and shorten the hospital stay.

scholarly journals Application of adaptive tools in relaparotomy wound surgery

2019 ◽  
Vol 100 (2) ◽  
pp. 351-357
Author(s):  
S G Izmaylov ◽  
M G Ryabkov ◽  
A E Leont’ev ◽  
V V Beschastnov ◽  
A G Izmaylov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Wound Closure ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Clinical Effectiveness ◽  
Main Group ◽  
Wound Surface ◽  
Severity Grade ◽  
Mechanical Methods ◽  
Complicated Course

Aim. To evaluate the clinical effectiveness of the developed adaptive tools for mechanical treatment of wound surface and suturing of relaparotomy wounds. Methods. 55 patients aged 43 to 79 years after relaparotomy operated on for various acute surgical diseases of the abdominal cavity were treated. In the main group (n=22. average age 63.5±4.75 years) in uncomplicated and complicated course of the wound process after relaparotomy for treatment of the wound surface and wound closure, adaptive tools were used as proposed by the authors. In the comparison group (n=33, average age 62±6 years; p=0.98) traditional mechanical methods of wound defect sanation and wound suturing (simple nodal, 8-shaped and U-shaped sutures) were used. Monitoring of relaparotomy wound healing was performed using an ultrasound method. The analysis of postoperative local complications in the discussed groups of patients was carried out according to Clavien-Dindo classification. Results. In patients of the main group, the multiplicity of wound surface treatment decreased by 1.8 times compared to the comparison group. There were no cases of damage to the underlying tissues of the wound edges. Wound postoperative complications corresponded to severity grade I, II, and IIIa according to Clavien-Dindo classification: in the main group - 27.3% and in the comparison group - 54.5%. Suppuration occurred respectively in 9.1 and 33.3% of patients (p=0.049). Conclusion. The developed adaptive tools are safe and effective mechanical means of prevention of wound postoperative complications after relaparotomy.

scholarly journals CURRENT ASPECTS OF DIAGNOSTICS AND TREATMENT OF ACUTE BILLARIAN PANCREATITIS

2018 ◽  
Vol 14 (3-4) ◽  
pp. 74-79
Author(s):  
I.V. Kolosovych ◽  
B.H. Bezrodnyi ◽  
I.V. Hanol
Keyword(s):  
Acute Pancreatitis ◽  
Length Of Stay ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Main Group ◽  
Duct System ◽  
Results Of Treatment ◽  
Positive Clinical Effect ◽  
Number Of Patients ◽  
Comparative Group

Relevance. The article is devoted to the problem of diagnosis and treatment of acute biliary pancreatitis, which remains one of the most common surgical diseases of the abdominal cavity and accounts for 33.2% of the total number of patients with acute pancreatitis. Objective of the work is to improve the diagnosis and results of surgical treatment of patients with acute pancreatitis of biliary etiology. Materials and methods. The results of treatment of 264 patients with acute pancreatitis of biliary etiology are analyzed. Operative treatment was applied in 92 (34,8 %) patients: endoscopic operations were performed in 44 patients (16,7 %). Thus, in 10 (3,8 %) patients, endoscopic papilloprotectomy was performed with the auditory of the duct system and the extraction of concrements. In other cases, organo-preserving intervention was performed without disturbing the morphofunctional integrity of the sphincter apparatus of the duct system: the cannulation in 6 (2,3%) patients, mechanical (balloon) in 5 (1,9 %) cases, pharmacological (myogenic antispasmodic) dilatation of distal duct and a large duodenal papilla in 11 (4,2 %) patients. In residual choledocholithiasis, a technique of papillotomy under the control of choledochoscopy was proposed – 12 (4,54 %) patients. A comparative analysis of the effectiveness of the treatment of patients who used the "open" (comparative group) and noninvasive endoscopic interventions in the early disease (the main group) was performed. Results. So in the main group the length of stay in the hospital was 12±3,2 days, respectively, in the comparison group – 26±4,3 days. In 42 (95,4 %) patients who had undergone endoscopic surgery, a positive clinical effect, a rapid regress of the symptoms of acute pancreatitis was achieved. In two (4,5 %) patients in the main group, the course was complicated by the development of the abscess of the stuffing box, and puncture under ultrasound control was performed. In patients of the comparison group complications arose in 5 (41,6 %) patients, it is noteworthy that all of them had undergone operative interventions, which were limited only to the rehabilitation and drainage of the abdominal cavity, a stuffing box bag. The mortality rate among unopposed was 1,2 % (2 patients), and among the operated – 11,9 % (11 patients). Among prooperated patients who died, 81,8 % (9 people) were elderly patients. Conclusions. The use of minimally invasive endoscopic interventions in the early phase of the disease reduces the length of stay of patients in the hospital from 26±4,3 days (comparison group) to 12 3,2 days (main group) and the number of complications occurring by 37,1 % (P <0, 05). Application of the proposed method of papillotomy under the control of choledochoscopy makes it possible to reduce the risk of perforation of the wall of the duodenum with the development of peritonitis or retroperitoneal phlegmon by 1,2 % (P <0,05).

scholarly journals MODERN METHODS OF PREVENTION AND TREATMENT OF COMPLICATIONS OF CERVICAL ESOPHAGO-ORGAN ANASTOMOSIS AT ESOPHAGOPLASTY

2020 ◽  
Vol 73 (8) ◽  
pp. 1696-1699
Author(s):  
Volodymyr O. Shaprynskyi ◽  
Yevhen V. Shaprynskyi ◽  
Mustafa Bassam Hussein ◽  
Oleg O. Vorovskyi ◽  
Yaroslav V. Karyi ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Postoperative Period ◽  
Comparison Group ◽  
Postoperative Mortality ◽  
Diagnostic Algorithm ◽  
Main Group ◽  
Instrumental Method ◽  
Complication Risk ◽  
Esophageal Strictures ◽  
Bed Days

The aim: To improve the results of operative treatment of esophageal strictures by decreasing the rate of failure and stricture of cervical esophago-organ anastomoses. Materials and methods: There were 45 patients with post-burn corrosive gullet strictures, 17 patients with postoperative corrosive strictures, 10 patients with peptic strictures secondary to reflux-esophagitis, 42 patients with esophageal cancer strictures. The patients were divided into two groups: the comparison group – 55 persons and the main group – 59 persons. Patients of comparison group underwent surgical treatment of esophageal strictures according to classic protocols and standards. In the main group of patients we applied proposed diagnostic algorithm with prediction of complication risk and the designed method of esophago-organ anastomosis formation. Results: The results of operative treatment in patients with esophageal strictures showed the development of early postoperative complications in 59 individuals (51.75 %). In the postoperative period six patients died: four – in the comparison group and two – in the main group. Failure of cervical esophago-organ anastomosis and esophageal strictures occurred in 7 patients (11.86 %) of main group and 20 patients (36.36 %) of the comparison group (p<0.05). Conclusions: Application of method predicting the risk of complications of cervical anastomosis, treatment program and instrumental method of formation anastomosis resulted in reduced incidence of failure and strictures of esophago-organ anastomosis from 36.36 % to 11.86 % (p<0.05); decreased time of hospitalization - from 28.2 ± 1.1 to 21.5 ± 0.5 bed-days (p<0.001), postoperative period - from 20.5 ± 1.1 to 16.1 ± 0.7 bed-days (p<0.01); decreased postoperative mortality - from 7.27 % to 3.39 %.

scholarly journals Surgical tactics for victims of gunshot wounds of the diaphragm specialized stage of medical care in conditions of a modern armed conflict

2019 ◽  
Keyword(s):  
Surgical Treatment ◽  
Medical Care ◽  
Comparison Group ◽  
Care Delivery ◽  
Abdominal Cavity ◽  
Surgical Care ◽  
Gunshot Wounds ◽  
Main Group ◽  
Lung Capacity ◽  
Combat Injuries

Introduction. The diaphragm gunshot wounds are serious combat injuries. The main functions of the diaphragm are to change the intra-abdominal pressure and the outflow of lymph and blood from the abdominal cavity due to the constant contraction and relaxation. Therefore, when it is injured at the same time with a powerful painful impulse, cardiopulmonary disorders quickly arise. Purpose: To improve the results of surgical treatment of patients with gunshot wounds through the introduction of new video endoscopic technologies at the stage of specialized surgical care. Materials and methods. The article analyzes the features of specialized surgical care in 64 patients with gunshot wounds who were treated at the surgical clinic of the Military Medical Clinical Center of the Northern Region (III level of medical care). New minimally invasive methods are proposed to improve the outcomes of surgical treatment of victims with diaphragm gunshot wounds at level III of health care delivery. Results. Thus, the use of video thoracoscopic technique in the surgical treatment of the diaphragm wound and its suturing in the proposed method allowed to improve the results of treatment by increasing the average value of diaphragmatic excursion in deep breath in the main group to 3.73 ± 0.31 cm, whereas in the comparison group 2.21 ± 0.38 cm. The severity of the pain syndrome on the of Visual Аnalogue Scale 5 days after surgical treatment was 5.2 ± 2.3 points in the injured main group, 6.7 ± 2.1 points in the comparison group. The ratio of vital lung capacity to the required vital lung capacity in the main group was 75.3 ± 2.2%, in the comparison group 64.1 ± 1.7%. Conclusions. The use of video thoracoscopy increases the efficiency of the diagnosis of gunshot wounds of the diaphragm. The use of laser imaging and fluorescence diagnosis of diaphragm wounds ensure the adequacy of the removal of paravulary necrotic tissues. The suturing of the wounds in accordance with the anatomical and functional structure of the diaphragm with the use of plaques improves the immediate postoperative results of surgical treatment.

scholarly journals Diagnostics and treatment of abdominal complications after gynecological endoscopic operations

2021 ◽  
Vol 1 ◽  
pp. 75-79
Author(s):  
Yu.P.  Vdovichenko ◽  
V.I.  Boyko ◽  
V.A.  Terehov
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Main Group ◽  
Laparoscopic Technique ◽  
Control Group ◽  
Diffuse Peritonitis ◽  
Abdominal Complications

The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.

scholarly journals Surgical correction of the chronic liver purulent-septic lesions

2019 ◽  
Vol 41 part 2 (2) ◽  
pp. 12-18
Author(s):  
O. G. Kotenko ◽  
A. V. Gusev ◽  
O. O. Popov ◽  
A. V. Grinenko ◽  
M. S. Grigoryan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Chronic Liver ◽  
Study Group ◽  
Anatomical Resection ◽  
Duration Of Treatment ◽  
Surgical Interventions ◽  
Liver Abscesses ◽  
Resection Of The Liver

Purpose of the study. The purpose of the study is to improve the results of surgical treatment of patients with purulent-septic lesion of the liver substantiating the indication for resection method use. Material and methods. The work is based on a comparative analysis of the results of examination and treatment of 64 patients aged 10 to 81 years old, with chronic liver abscesses in the department of surgery and liver transplantation during the 1995–2016 periods. According to the tasks of the study patients are divided into two groups. In 30 (46,8%) patients (the study group), various types of anatomical resection of the liver with a purulent lesion were performed without its dissection during the operation; in 34 (53,2%) patients (group of comparison) they performed the disclosure, sanation, drainage of purulent cavity. The majority of patients with chronic liver abscesses treated the abscess with a puncture or drainage method under the control of ultrasound in other medical institutions of Ukraine. Results. The results of diagnosis and treatment of 64 patients for chronic liver abscesses from 1995 to 2016 are analyzed. In the study group, the patients performed anatomical resection of the liver, in the comparison group – standard surgical interventions – the disclosure and drainage of the abscess of the liver. The duration of antibiotic therapy after surgery in the comparison group is significantly higher than in the study group, respectively, 22 ± 3,4 and 5,75 ± 1,6 days; p < 0,001. Second-line antibacterial drugs after draining operations were used more often (p < 0,001) than after resection interventions, respectively, in 94,1 and 6,6% of cases. The duration of treatment of patients in the hospital after surgery in the study group was less than in the comparison group, according to 15,1 ± 0,7 and 27,3 ± 3,05 days; total 25,9 ± 1,4 and 45,7 ± 3,45 days (p < 0,001). After drainage operations, drainages from the abdominal cavity were removed later than after resection interventions, respectively, 17,1 ± 2,8 and 6,35 ± 1,1 days (p < 0,001), through. Conclusion. Resection for chronic purulentseptic lesions of the liver is the priority methods of surgical treatment. The analysis of the obtained results allows us to conclude that resection technologies contribute to the rapid normalization of physical and social rehabilitation of patients with septic liver damage. Keywords: liver abscess, liver resection, chronic, purulent-septic.

INDICATIONS AND CONTRAINDICATIONS FOR REMOVAL OF FOREIGN BODIES OF LUNGS OF FLAMMABLE ORIGIN

2021 ◽  
pp. 43-47
Author(s):  
V. Kupriyanchuk ◽  
Y. Bunin ◽  
R. Mikhailusov ◽  
V. Negoduyko ◽  
E. Khoroshun ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Foreign Bodies ◽  
Comparison Group ◽  
Gunshot Wounds ◽  
Northern Region ◽  
Main Group ◽  
Surgical Instruments ◽  
Surgical Trauma ◽  
Surgical Interventions ◽  
Surgical Department

Summary. The purpose of the study is to establish the indications and contraindications for the removal of foreign bodies of lungs of gunshot origin. Materials and methods. In the surgical department of the surgical clinic of the Military Medical Clinical Center of the Northern Region, 207 wounded who received gunshot wounds penetrating the chest were examined. The wounded were divided into 2 groups depending on the operational tactics used. The main group of 97 wounded who were treated using modern video endoscopic technology and magnetic surgical instruments. The comparison group consisted of 110 wounded who received traditional treatment. Results and their discussion. Using video endoscopic technologies and magnetic surgical instruments during surgery, 42 (54.5%) in the main group were removed, in the comparison group — 23 (27.4%) foreign bodies. The amount of surgery should not exceed the amount of damage that minimizes surgical trauma. The article presents indications and contraindications to the removal of foreign bodies of pulmonary origin. The differential approach allows to determine the surgical tactics depending on the location of the foreign body, its size and the fit of foreign bodies to the vessels, bronchi, mediastinum. Adherence to the rules of removal of foreign bodies of the lung, depending on the location of its location and size leads to a decrease in inappropriate surgical interventions and postoperative complications. Conclusions. 1. The distribution of foreign bodies by location and size allows you to clearly determine the tactics of treatment and avoid postoperative complications. 2. Surgical interventions to remove foreign bodies should be performed in the first days after stabilization of the patient’s condition using minimally invasive technologies.

scholarly journals THE POSSIBILITIES OF APPLICATION OF DECIMETER-WAVE THERAPY IN DESTRUCTIVE APPENDICITIS CHILDREN

2019 ◽  
Vol 23 (1) ◽  
pp. 4-8
Author(s):  
Ekaterina R. Soloveva ◽  
O. V. Karaseva ◽  
M. F. Vasileva ◽  
S. V. Petrichuk
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Comparison Group ◽  
Abdominal Ultrasound ◽  
Main Group ◽  
Inpatient Stay ◽  
Decimetric Wave ◽  
Insufficiency Syndrome ◽  
Common Laboratory ◽  
Inflammatory Effect

Introduction. The article presents a comparative study of the postoperative period after laparoscopic appendectomy for destructive appendicitis in children with and without application of decimetric-wave therapy (DMWT). Material and methods. The study included 299 children aged from 3 to 17 years, the average age of children accounted for 10.7 ± 3.3 years. Patients were operated on for various forms of destructive appendicitis. The patients observed included 201 boys (67.3%) and 98 girls (32.7%), Destructive appendicitis (DA) was diagnosed in 129 (43.1%) children, appendicular peritonitis (AP) - in (56.9%). Patients of the main group received DMWT, starting from the 1st day after surgery. Patients in the comparison group did not receive physiotherapy. To assess the effectiveness of the use of UHF-therapy in the postoperative period, the following groups were taken into account: 1) intestinal insufficiency syndrome (ISS) and systemic inflammatory response syndrome (SSRS); 2) postoperative complications; 3) abdominal ultrasound data; 4) the dynamics of common laboratory indices 4) the duration of the inpatient stay. Results. In DA cases without peritonitis, ISS and SSRS in the main group were observed by 15.7 and 12.8 times less than in the comparison group, with the duration of ISS decreased by 2.13 times, SSRS by 3.3 times. In AP patients the frequency of ISS decreased by 1.68 times, SSRS - by 1.97 times. By the 5th day of the postoperative period in the main group, both in DA and AP cases, there was a significant increase in the incidence of patients with both leukocytes and lymphocytes count normal for the age, LII, CRP. The inpatient stay in the main group decreased by 1.0±0.7 days in DA patients, in AP cases - by 3.3±0.7 days. Conclusion. Evaluation of the postoperative period, as well as traditional laboratory indices, confirm the effectiveness of DMWTin the postoperative period in DA cases YES, in that the local and systemic anti-inflammatory effect is more pronounced in with AP patients.

scholarly journals Experience of application of interventional sonography in treatment of patients with bacterial hepatic abscesses

2020 ◽  
Vol 87 (3-4) ◽  
pp. 31-34
Author(s):  
M. V. Bezruchko ◽  
S. I. Panasenko ◽  
O. S. Osipov ◽  
V. S. Drabovskyi ◽  
Ya. V. Rybalka
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Bile Leakage ◽  
Complex Configuration ◽  
Abscess Cavity ◽  
Hepatic Parenchyma ◽  
Sonographic Guidance ◽  
Results Of Treatment ◽  
Bed Days ◽  
Dynamical Control

Objective. To analyze the possibilities and efficacy of application of the intervention sonography in complex surgical treatment of patients with bacterial hepatic abscesses. Materials and methods. Results of treatment of 39 patients with hepatic abscesses in Department of Surgery № 3 through period from 2012 till June 2019 yr was presented. The patients were treated, using the puncture aspiration or drainage of abscesses under sonographic guidance. In hepatic abscesses with diameter up to 40 mm a puncture sanation was applied. In all the patients transcutaneous drainage was performed, not depending from the abscesses dimensions and localization. Results. Treatment and application of the intervention sonography was effective in 37 (94.9%) patients. Postoperative complications have occurred in 4 (10.3%) patients: hemorrhage inside the abscess cavity (in 2), durable bile leakage via the drain (in 1), migration of the drain from the abscess cavity (in 1). Average stationary stay of the patients was (19,2 ± 1,6) bed-days. Conclusion. Application of the puncture-draining procedures under sonographic control in treatment of patients, suffering hepatic abscesses constitutes a method of choice, what is caused by their small traumaticity, availability of dynamical control and efficacy in 94.9% patients. But these procedures owe some limitations, connected by the abscesses quantity, their localization, as well as complex configuration and big possibility of presence of large sequesters of necrotized hepatic parenchyma.

scholarly journals "FAST-TRACK" IN SIMULTANEOUS OPERATIONS AGAINST THE BACKGROUND OF WIDESPREAD PERITONITIS

2018 ◽  
Vol 25 (5) ◽  
pp. 141-146
Author(s):  
V. Yu. Mykhaylichenko ◽  
O. Yu. Gerbali ◽  
U. I. Basnaev ◽  
N. E. Karakursakov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Fast Track ◽  
Comparison Group ◽  
Clinical Laboratory ◽  
Average Duration ◽  
Main Group ◽  
Simultaneous Operations ◽  
Duration Of Hospitalization ◽  
Recovery Program

Aim. This research was conducted to study the possibility and effectiveness of the "Fast-track" fast recovery program application when performing simultaneous operations against the background of widespread peritonitis.Materials and methods. In the course of the study were examined 66 patients, the ratio of woman/man was 45:21. The main group – 32 (48,5%) patients with the major disease of constricted postoperative hernia complicated by the widespread peritonitis and chronic calculous cholecystitis (a prospective analysis of surgical treatment). The comparison group – 34 (51,5%) patients with the identical pathology – the retrospective analysis of surgical treatment. The treatment of patients of the main group was supplemented with the application of the elements of the «Fast-track» program. Whereas, the treatment of patients of the comparison group was performed exclusively according to the standard scheme of the patient management with widespread peritonitis.Results. Clinical, laboratory and instrumental data indicate the positive effect of the "Fast-track" program on the process of rehabilitation of patients in the postoperative period. There was a significant acceleration in the recovery of motorevacuation function of the intestine in patients of the main group in relation to the comparison group and a smaller number of complications in the main group in relation to the comparison group against the background of the application of this technique. As a result, the average duration of hospitalization of patients from the comparison group was 10- 5 days (average 12±2,4 days). While the average duration of hospitalization of patients from the comparison group was 17-20 days (on average 18±1,2 days).Conclusion. The use of the "Fast-track" program in simultaneous operations does not increase the effectiveness of surgical treatment, thereby accelerating the process of rehabilitation of patients in the postoperative period. 

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