FUNCTIONAL ACTIVITY OF THE BILIARY SYSTEM AFTER CHOLECYSTECTOMY IN THE LONG-TERM REHABILITATION PERIOD

Abstract

Nowadays, laparoscopic cholecystectomy is the main method of surgical treatment of gallbladder diseases, especially gallstone disease. Recovery measures after surgery during the long-term rehabilitation phase should be aimed at maintaining the functions of the biliary system, which ensures proper digestion and improves the patient's quality of life. The aim of the study was to investigate the dynamics of bile secretion by multimoment fractional duodenal ultrasound (MFDU) in patients after laparoscopic cholecystectomy during the long-term rehabilitation phase. The study involved 27 patients, of whom 19 (70,37%) were women and 6 (29,63%) were men. The age of the subjects ranged on average from 35 to 60 years. The subjects were divided into two groups, one of which took only medications (n=14), and the other, in combination with pharmacological drugs, had certain types of rehabilitation intervention (n=13). Results: The duration of phase I significantly decreased, and the volume of bile increased (p<0,05) in patients of group I, in patients of group II these indicators had a more pronounced dynamic (p<0,001). The duration of phase II in patients who had only pharmacological management was prolonged by 18,6% (p<0,05), in patients who underwent rehabilitation by 45.6% (p<0,001). The time of bile secretion during phase III significantly decreased in both groups (p<0,05), (p<0,001). The amount of bile secreted during phase III in patients of both groups significantly decreased (p<0,05), (p<0,001). The time of bile secretion and its volume during phase V significantly decreased in patients of both groups (p<0,05), (p<0,001). Thus, the effectiveness of rehabilitation intervention in patients of group II after laparoscopic cholecystectomy was proved by a significant improvement (p<0,001) in the functioning of patients at the level of structure and normalization of the function of the hepatobiliary system and gastroduodenal area, which was manifested in a decrease in pain and manifestations of dyspeptic disorders in the form of nausea and diarrhea. Thus, the rehabilitation of patients after laparoscopic cholecystectomy with the inclusion of physical therapy (physical rehabilitation) in the individual program, patient education on nutrition, leisure, lifestyle is an extremely important and basic component of physiological recovery.