Keywords
Abstract
Laparoskopik xoletsistektomiya bugungi kunda o‘t pufagi tosh kasalligi va uning asoratlarini davolashda “oltin standart” hisoblanadi. Biroq ushbu amaliyotda uchraydigan eng xavfli va klinik jihatdan og‘ir oqibatlarga olib keluvchi holatlardan biri — o‘t yo‘llari shikastlanishi bo‘lib, bu asorat ko‘pincha Calot uchburchagi anatomik tuzilmalari noto‘g‘ri identifikatsiya qilinganda yoki anatomik variantlar e’tibordan chetda qolganda yuzaga keladi. Calot uchburchagi hududida joylashgan o‘t pufagi arteriyasi, umumiy jigar yo‘li, sistik yo‘l hamda qo‘shimcha arteriyalar va anomaliyalar jarrohlik amaliyoti paytida xatolik ehtimolini oshiradi. Mazkur ilmiy maqolada Calot uchburchagining klassik va zamonaviy anatomo-jarrohlik talqinlari, sistik arteriya va sistik yo‘lning uchraydigan variantlari, shuningdek, laparoskopya vaqtida vizualizatsiya va disseksiya texnikasining muhim jihatlari keng tahlil qilinadi. Ayniqsa, “Critical View of Safety” (CVS) konsepsiyasi, infundibulyar texnika xatolari, yallig‘lanishli o‘zgarishlar fonida anatomik orientirlarning yo‘qolishi hamda jarrohlik taktikasi o‘zgarishi zarur bo‘ladigan holatlar ilmiy asosda yoritiladi. Shuningdek, o‘t yo‘llari shikastlanishining patogenezi, xavf omillari, erta diagnostika va profilaktik yondashuvlar, jumladan, intraoperatsion xolangiografiya, “bail-out” strategiyalari (subtotal xoletsistektomiya, konversiya) hamda zamonaviy energiya qurilmalaridan oqilona foydalanish masalalari ham ko‘rib chiqiladi. Tadqiqot natijalarini umumlashtirish orqali laparoskopya jarrohligida Calot uchburchagi anatomiyasini chuqur bilish, CVS tamoyiliga qat’iy rioya qilish va murakkab holatlarda xavfsiz alternativ taktikalarga o‘tish o‘t yo‘llari shikastlanishi va qon ketish kabi og‘ir asoratlarni sezilarli kamaytirishi mumkinligi asoslab beriladi. Ushbu maqola jarrohlar, rezidentlar hamda endoskopik jarrohlik amaliyoti bilan shug‘ullanuvchi mutaxassislar uchun amaliy ahamiyatga ega bo‘lib, operatsion xavfsizlikni oshirishga xizmat qiladi.
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