COMPLEX REHABILITATION OF PATIENTS UNDERGONE CHOLECYSTECTOMY DUE TO BILIARY STONE IN SANATORIUM «LIVADIA»

Abdulganieva D.I. 2, Makarova L.G. 1, Martinova L.A. 1, Potapova Z.R. 1

Sanatorium "Livadia«1, Kazan State Medical University2, Kazan, Russia

livadia_07@mail.ru

Prevalence of biliary stones in Russia is between 5-20% among gastrointestinal diseases. Nowadays the main treatment of biliary stones is cholecystectomy. After the surgery clinical symptoms are persisting or may appear new ones in 25-40% of patients and need to be treated. Rehabilitation of patients after cholecystectomy should be started as soon as possible to reduce postsurgical symptoms rate and decrease economical expenses of the government (duration of disability list staying).

Sanatorium «Livadia» (Kazan, Russia) offers complex of rehabilitation in patient’s undergone cholecystectomy. Since 2005 till September 2009 1178 patients were admitted to «Livadia» after the biliary stones surgery, male — 283 pts (24%), female — 895 pts (76%). The majority of patients had endoscopic cholecystectomy 91,2% (1095 pts), short-scar incision — 4,8% (56 pts), laparotomy cholecystectomy — 4,0% (47 pts). Concomitant diseases were seen in 78% of patients: steatosis — in 64% pts, arterial hypertension — in 63%, peptic ulcer disease — 19%, thyroid diseases — 4%.

Patients were referred from surgical units at day 5-7 after surgery. All patients haven’t shown any clinical symptoms of choledocholithiasis. Main clinical features were: asthenic syndrome (82%), discomfort in postsurgical area (61%), dyspepsia (56%), stool impairment (mostly constipation — 38%).

Mineral water «Livadia» was included in complex of early rehabilitation from the first day of staying in sanatorium. Mineral water «Livadia» is a water of minor mineralization (mineralization — 2,0-2,3 g/dm3, sulfated magnesium-calcic compound with neutral reaction — рН 6,8-7,1). Also the complex of early rehabilitation at the first stage included differential nutrition support (depended of co-morbidities), movement therapy, physiotherapy.

At the end of the first week asthenic syndrome was jugulated in 40% of cases (p<0,05), dyspepsia was reduced twice — presented only in 38% (p<0,05), constipation was seen only in 17% of cases, discomfort in postsurgical area was jugulated in 47% of cases.

At the second stage of rehabilitation physiotherapy was extended and balneologic methods of rehabilitation were continued.

Represented data proves that complex of early rehabilitation procedures has a positive impact on patients with cholecystectomy.