Journal of Clinical PracticeJournal of Clinical PracticeКлиническая практика2220-30952618-8627Eco-Vector5804710.17816/clinpract58047ReviewsНаучные обзорыReview ArticleSimultaneous surgeries in bariatric surgery (literature review)Симультанные операции в бариатрической хирургииhttps://orcid.org/0000-0003-3897-83065619-1151SmirnovAlexander V.СмирновАлександр Вячеславович
Russian Federation

MD, PhD

к.м.н.

alvsmirnov@mail.ruhttps://orcid.org/0000-0002-8620-8755StankevichVladimir R.СтанкевичВладимир Романович
Russian Federation

MD

v-stankevich@yandex.ruhttps://orcid.org/0000-0001-8539-4392PanchenkovDmitriy N. PanchenkovПанченковДмитрий Николаевич
Russian Federation

MD, PhD, Professor

д.м.н., профессор

dnpanchenkov@mail.ruhttps://orcid.org/0000-0002-1510-90473677-0208SharobaroValentin I.ШаробароВалентин Ильич
Russian Federation

MD, PhD, Professor

д.м.н., профессор

sharobarovi@mail.ruhttps://orcid.org/0000-0001-6209-41943240-4335IvanovYuri V.ИвановЮрий Викторович
Russian Federation

MD, PhD, Professor

д.м.н., профессор

ivanovkb83@yandex.ruhttps://orcid.org/0000-0002-0297-81559817-2850VelichkoYevgeny A.ВеличкоЕвгений Александрович
Russian Federation

MD, PhD

к.м.н.

velichko_eugen@mail.ruFederal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of RussiaФедеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства РоссииMoscow State University of Medicine and Dentistry named after A.I. EvdokimovМосковский государственный медико-стоматологический университет имени А.И. Евдокимова190120212612202011455631101202113012021Copyright ©; 2020, Smirnov A.V., Stankevich V.R., Panchenkov D.N., Sharobaro V.I., Ivanov Y.V., Velichko Y.A.Copyright ©; 2020, Смирнов А.В., Станкевич В.Р., Панченков Д.Н., Шаробаро В.И., Иванов Ю.В., Величко Е.А.2020Smirnov A.V., Stankevich V.R., Panchenkov D.N., Sharobaro V.I., Ivanov Y.V., Velichko Y.A.Смирнов А.В., Станкевич В.Р., Панченков Д.Н., Шаробаро В.И., Иванов Ю.В., Величко Е.А.https://creativecommons.org/licenses/by-nc-nd/4.0https://clinpractice.ru/clinpractice/article/view/58047

Based on the available publications, the article presents an analysis of the studies on the simultaneous implementation of cholecystectomy, ventral and paraesophageal hernia repair during a bariatric intervention. If there is a clinical picture of chronic calculous cholecystitis, simultaneous cholecystectomy is justified and does not lead to a significant increase in the number of complications. In the case of asymptomatic gallstones, the optimal tactics remains controversial, both a surgical treatment and observation are possible. In the absence of gallstone disease, all patients after the surgical correction of the excess weight are prescribed ursodeoxycholic acid, while performing preventive cholecystectomy is not recommended. A simultaneous ventral hernia repair is justified only for small defects (< 10 cm) of the anterior abdominal wall. If a paraesophageal hernia is detected in patients with morbid obesity, bariatric surgery may be combined with cruroraphy.

Представлен анализ исследований, посвященных проблеме симультанных холецистэктомий, пластики вентральной и параэзофагеальной грыж у пациентов с морбидным ожирением. При наличии клинической картины хронического калькулезного холецистита выполнение симультанной холецистэктомии представляется оправданным и не приводит к существенному увеличению числа осложнений. При бессимптомном камненосительстве оптимальная тактика остается спорной: возможно как хирургическое лечение, так и наблюдение. При отсутствии желчнокаменной болезни всем пациентам после хирургической коррекции лишнего веса показан прием урсодезоксихолевой кислоты, выполнение же профилактической холецистэктомии не рекомендуется. Симультанная пластика вентральной грыжи оправдана лишь при небольших дефектах (< 10 см) передней брюшной стенки. В случае выявления параэзофагеальной грыжи у пациентов с морбидным ожирением бариатрическая операция может сочетаться с крурорафией.

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