ENDOTHELIAL DYSFUNCTION AS A MARKER OF VENOUS THROMBOEMBOLISM RISK IN PATIENTS WITH ACUTE CALCULOUS CHOLECYSTITIS

Thromboembolic complications are a significant issue in modern medicine, being one of the leading causes of mortality and disability. Their prevalence in the general population ranges from 0.15 % to 2.1 %, with a mortality rate reaching 2.1-6.2 %. An analysis was conducted on the diagnosis and treatment of 300 patients who underwent laparoscopic surgery for gallstone disease at the Regional Center for Elective Surgery and Transplantology of Rivne Regional Clinical Hospital named after Y. Semenyuk between 2019 and Patients were divided into two groups: Group I included 162 patients (54%) who received prophylaxis for venous thrombosis after laparoscopic cholecystectomy according to approved thromboprophylaxis protocols, and Group II comprised 138 patients (46 %) who underwent prophylaxis based on a newly developed algorithm during the study. Minimal risk (0 points) was observed in 57 cases (19 %), low risk (1–2 points) in 204 cases (68 %), moderate risk (3-4 points) in 31 cases (10.3 %), and high risk (≥5 points) in 8 cases (2.7 %). Patients stratified according to J. Caprini's model exhibited differences in von Willebrand factor levels. In the control group, post-laparoscopic cholecystectomy (LCE) values ranged from 104.2±3.3 (p<0.05) to 122.9±3.2 (p<0.05) in patients with acute calculous cholecystitis, and from 287.4±3.1 (p<0.05) to 291.4±3.2 (p<0.05) in those with acute cholecystitis and varicose vein disease. The total blood oxyproline level in patients with connective tissue dysplasia exceeded normal values by 42.13 %. This finding indicates possible excessive collagen synthesis and/or insufficient degradation, potentially associated with pathological changes in connective tissue.