EUROMEDICA  Hanover 6-7  Juni 2008	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover Russian Academy of Natural Sciences, Moscow

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The principal method for treatment of cholelithiasis according to most specialists is surgical. About 2,5 mln. surgeries on gall bladder and biliary duct are performed every year. However the remote results attained by operation hardly may be considered satisfactory since 8 -20 % of the cases are followed up by the development of so-called post-cholecystectomic syndrome. For this reason the special attention is focused on non-medication method of treatment such as drinking water at a spa(1,2). In the period from 2003 to 2007, 890 patients with gall-stone who underwent cholicystectomy were involved into an early post –operation rehabilitation treatment at the spa “Polyana” whereas 128 patients who had laparoscopic cholecystomy in the surgical clinics in the city of Uzhgorod were under our observation. Before operational period of the disease development lasted from 1 till 20 years but in most patients - 3 years(72 %). Predominantly the group was comprised of women( 84 %), mainly able -bodied, 68 % had the planned operations not for exacerbation of the disease. Majority of the patients suffered some other concomitant disorders of other organs of digestion( chronic pancreas - 38 %, reactive hepatitis, dyskinesia of the large intestine -32%).126 patients treated in the spa after laparoscopic cholecystectomy done had the following symptoms complexes: 95, 7 % astheno - vegetative syndrome, 86 % -ailing syndrome, 40 % syndrome of stomach dyskinesia. 72,4% of the patients( 15,30 1,40 kg) gained extra weight, everyone got the accelerated ESR( 19,0 1,3 mm/per annum), hypoalbuminenia( 49,5 1,02 %) while the endoscopic examination testified that 58% of the patients had the gastropathia of various degree of development. The 24 days curative course for rehabilitation was based on the mineral spring water “ Polyana Kupil” heated up to 380 C, prescribed 150 - 200 ml per os 3 times a day for slow drinking before a meal. All patients endured the mineral water relatively good. They were prescribed the Pevzner diet n.5, general restorative and tonic procedures, pearl baths, tincture of ginseng,”Ployana Kupil “ mineral waterbaths, massage while they enjoy a free regime. When the curative course accomplished the astheno - vegetative syndrome was detected in 4, 5 - 12,5 % patients, no ailing syndrome was at all identified, statistically the frequency and manifestation of the syndrome of stomach dyskinesia was largely dropped while the content of album in the serum grew up to 52. 0 1,2( p<0,5), the endoscopy done identified less cases of gastropathia( 8/ 4 %). The early post- operative rehabilitation in the spa “Polyana “ was undertaken by 80 patients with stomach and duodenum ulcer. While 60 of them had the perforative ulcer developed and 20 had undergone the operation for acute stomach - intestine bleeding. Summary: So far the early post - operative spa rehabilitation( 1- 2 weeks post - operative) is recommended to the patients who underwent planned regular operation or laparoscopic cholecystectomy for the reason of cholelithiasis but not yet complicated. The patients whose illness take on grave and complicated form who have the operation done by traditional methods need the spa rehabilitation be prescribed for the remote post - operation period( 3-4 weeks post - operative). Our investigations testify that spa rehabilitation is required for the patients at the early stage post - laparoscopic chocystectomy done what makes it possible to cut down the duration of patients’ disability and forestall the post-cholecysctomy syndrome. The early postoperative rehabilitation of the patients who contracted the stomach ulcer and duodenum ulcer is very efficient but it calls for the further study and investigation thereof.