Minimally Invasive Methods of Treatment of Patients with Acute Cholecystitis

Abstract

Relevance. Gallstone disease occupies one of the first places among surgical diseases.

Materials and methods. The results of surgical treatment of 138 patients with acute cholecystitis were analyzed. The age of the patients ranged from 18 to 89 years, women predominated - 84.8%. The preoperative diagnosis of acute cholecystitis was based on clinical evaluation, laboratory findings, and radiographic evidence of acute cholecystitis.

Results. Laparoscopic cholecystectomy was performed in 25 (65.8%) patients of group 1 with mild course (Grade I) and 13 (17.3%) patients with moderate course (Grade II). In all cases, the gallbladder was enlarged, tense, often soldered to the greater omentum or surrounding organs. Puncture of the gallbladder with evacuation from 30 to 50 ml of bile was required in 31.6% of cases. Intraoperatively, signs of acute obstructive cholecystitis were detected in 47.4% of patients, phlegmon of the gallbladder with signs of its destruction - in 21% of patients. 36 patients underwent conventional cholecystectomy and 2 patients underwent laparoscopic cholecystectomy with drainage of the common bile duct according to Vishnevsky.

Findings. Laparoscopic cholecystectomy appears to be a reliable, safe and cost-effective procedure for acute cholecystitis. We believe that with a careful approach to acute cholecystitis, laparoscopic cholecystectomy will provide the best treatment for this condition.