Introduction. A number of professional questions, for instance, surgical management in patients with a higher operational risk in the presence of accompanying cardiovascular and respiratory diseases, as well as surgical management in elderly patients are still without the clear solution.
Aim of the work — to develop the surgical management for elderly patients with AC by comparative evaluation of laparoscopic cholecystectomy (LCE) and open cholsecystectomy (OCE) efficacy.
Materials and methods. There were 132 patients treated because of AC in the surgical department of the 10thOdessaMunicipalHospital during 2012–2014 years. The age of patients ranged from 29 to 69 with an average age equal to (53.6±5.8) years. More often surgical interventions were done laparoscopically — 86 (65.2%) operations. All the rest — in the traditional way using OCE. All patients were retrospectively divided into two clinical groups: the patients of the 1st group — 86 (65.2%) were executed the LCE. There were 46 patients with acute cholecystitis (AC) in the 2nd group were operated using OCE.
Results and discussion. LCE was successful in 83 of 86 cases. The presence of infiltration in the cervical area of the gallbladder were the reasons of conversion. There were 5 cases of postoperative complications in group 1 (5.8%) and 9 cases in group 2 (19.6%). Our data revealed an important fact — LCE safety in elderly patients. There were 34 operations in patients aged over 60 years, 25 of which were initiated laparoscopically (73.5%, only 1 case of conversion) and 9 (26.5%) — done traditionally through OCE. Both duration, manifestation of postoperative period and number of complications (totally — 14 in both groups) did not differ significantly in elderly patients operated by different surgical methods.
Conclusions. Using data obtained the authors concluded that LCE in patients aged over 60 years contributes to the pathological process elimination, easy postoperative period manifestation and complications absence. Available interpretation of ADC patients’ age as the operational risk for such surgery refuted by satisfactory results of 86 patients clinical observation after LCE. LCE was performed in 25 cases of 34 patients aged over 60 years that, according to the authors’ opinion, evidenced in favor LCE reasonability in surgical management choice in case of surgical treatment of elderly patients with ADC using the minimally invasive technologies advantages.