Acute cholecystitis: quo vadis? Experience of 13,000 operations in one clinic

Автор: Lutsevich O. E.

Журнал: Московский хирургический журнал @mossj

Рубрика: Абдоминальная хирургия

Статья в выпуске: 2 (76), 2021 года.

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Relevance. Surgical treatment of acute cholecystitis (AC) remains one of the most urgent problems of emergency surgery. AC is the most frequent complication of gallstone disease, reaching 30% or more in the structure of this disease. Despite the widespread introduction of modern endoscopic surgical techniques, there are still many unresolved problems in the treatment of AC.Material and methods. This paper summarizes the experience of treating more than 13,000 patients with GBD who underwent laparoscopic cholecystectomy. Acute cholecystitis occurred in 3140 patients. The author adheres to active surgical tactics - laparoscopic surgery in the first 2-16 hours from admission in the absence of absolute contraindications to the pneumoperitoneum.Results. The paper discusses the technical features of laparoscopic operations in various forms of AC, discusses the reasons for unsatisfactory results of surgical treatment of AC, such as late hospitalization and the use of ineffective conservative therapy, delaying the recovery of patients. The negative consequences of multi-stage AC treatment methods are discussed, and an algorithm for early radical surgical intervention is defined. The nature of inflammatory changes in the GB wall and nearby space tissues, as well as the presence of adhesions in the abdominal cavity, did not affect the decision on the timing of the operation and the choice of method.


Acute cholecystitis, surgical tactics, early laparoscopic cholecystectomy, causes of treatment failure

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IDR: 142230023   |   DOI: 10.17238/issn2072-3180.2021.2.18-25

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