THE PROBLEM OF CHOLECYSTECTOMY AND INDICATIONS FOR SURGERY

Abstract

The study highlights the need for comprehensive preventive measures to improve surgical outcomes for acute cholecystitis. The lack of such measures is linked to postcholecystectomy syndrome (PCES), which affects 14.6% of patients. Main causes include choledocholithiasis (54%), spinal cord stenosis (43%), and intraoperative injuries (27%). A developed questionnaire method showed high effectiveness in identifying true PCES, with sensitivity at 96% and specificity at 91%. Implementing a comprehensive prevention strategy, including integrated clinical and laboratory assessments and CDS data, can reduce the incidence of true PCES by 2.4 times and decrease the likelihood of unsatisfactory long-term results by 45.1%.