SURGICAL APPROACH IN THE TREATMENT OF PATIENTS WITH ACUTE CALCULOUS CHOLECYSTITIS

Abstract

Aim. To improve the results of treatment of patients with acute calculous cholecystitis Material and methods. The results of the diagnosis and treatment of 90 patients with AOC were analyzed. The main group (the 1st group) included 38 patients who received a two-stage treatment approach with laser therapy. The control group (2nd group) included 52 patients for whom the treatment concept comprised only laparoscopic cholecystectomy. Results and discussion. The complications of AOC before the operation included 9 (23.7%) cases of peri-vesical infiltration in the first group and 11 (26.2%) cases in the second group. Gallbladder empyema made 2 (5.3%) cases in the first group, and 4 (9.5%) cases - in the second group. Most of the patients of the second group patients were operated in 72 hours from the moment of obstruction, while the first group patients received the improved two-step approach in 72 hours from the moment of obstruction. In the postoperative period, local complications were observed more often in the second group. Conclusion. The comprehensive diagnostic approach induces correct and timely diagnosis and makes possible the start of adequate therapy. In the case of the gallbladder obturation, after 72 hours improved two-stage tactic is preferable.