EXPERIENCE IN THE TREATMENT OF COMPLICATED ACUTE CHOLECYSTITIS

Objective: the choice of optimal surgical management, method and sequence of surgery in patients with acute cholecystitis.

Methods. The paper presents an analysis of results of treatment of 178 patients with complicated acute cholecystitis of different severity. One-stage surgery with the performance of laparoscopic cholecystectomy (LCE) was used in the treatment of 106 (59.6%) patients, two-step — in 57 (32.1%)  cases, a three stage — in 12 (6.7%) patients with high operational сholeсysthocholedocholithiasis with high surgical and anaesthesiological risk.

Results. The use of a differentiated approach to the choice of optimal surgical treatment in patients with complicated acute cholecystitis with using mini-invasive technologies has made it possible to increase the share of LCE to 95.5%, lower rates of postoperative complications from 23.8 to 13.4% and mortality which was not caused by the basic disease dicreased from 3.9 to 1.7%.

Conclusion. In the article there was explained and proved a necessity in mini-invasive surgery for acute cholecystitis and cholelithiasis complicated forms.