ЕНДОТЕЛІАЛЬНА ДИСФУНКЦІЯ У ХВОРИХ НА ГОСТРИЙ КАЛЬКУЛЬОЗНИЙ ХОЛЕЦИСТИТ З РИЗИКОМ ВЕНОЗНОГО ТРОМБОЕМБОЛІЗМУ

Venous thromboembolic complications (VTE), including deep vein thrombosis and pulmonary embolism, represent a significant issue in modern medicine, ranking among the leading causes of mortality and disability. In the general population, the incidence of VTE ranges from 0.15 % to 2.1 %, with a mortality rate of 2.1 % to 6.2 %. According to some studies, nearly 25 % of the global population encounters VTE during their lifetime. This study analyzed the diagnosis and treatment of 300 patients who underwent laparoscopic surgery for gallstone disease at the Regional Center of Planned Surgery and Transplantology of Rivne Regional Clinical Hospital named after Yu. Semeniuk, from 2019 to 2023. All patients were divided into two groups: Group I included 162 patients (54 %) who received venous thrombosis prophylaxis following approved thromboembolism prevention protocols after laparoscopic cholecystectomy, and Group II included 138 patients (46 %) who underwent prophylaxis based on an algorithm developed during this study. Risk stratification revealed that 57  patients (19 %) were at very low risk (0 points), 204 patients (68 %) at low risk (1-2 points), 31 patients (10.3 %) at moderate risk (3–4 points), and 8 patients (2.7 %) at high risk (≥5 points). The study demonstrated that in patients hospitalized for acute calculous cholecystitis, the serum endothelin-1 level was 0.89 fmol/ml before laparoscopic cholecystectomy. After surgery, the endothelin level increased by 0.39 fmol/ml, reaching 1.28 fmol/ml. These results indicate that endothelin levels before and after surgery differ minimally. This finding may have practical implications, as the post-operative increase in endothelin levels could signify the preservation of normal endothelial function and the absence of severe complications. The assessment of VTE and thromboembolism risk using the modified J. Caprini risk model allows for a more precise and  individualized approach to the prevention and management of venous thromboembolism.