[Tactics of treatment of the acute cholecystitis complicated by choledocholithiasis].

ABSTRACT

In this article is present the comparative analysis of the results of different surgical approaches of 201 patients with acute cholecystitis complicated by choledocholithiasis. In the 1st group of 70 (34.8%) patients in the first stage of treatment applied percutaneous cholecystostomies (PC). Retrograde endobiliary interventions endoscopic sphincterotomy (ES) were performed in the second stage before LC. In the 2nd group 131 (65.2%) patients underwent for treatment include preoperative endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy (ERCP/ES) followed by laparoscopic cholecystectomy (LC). The complications of retrograde interventions was higher by 3.5 times in the group of patients without prior decompression of the gallbladder. The surgical treatment was performed by 70 patients of the first group and by 79 (60.3%) patients of the second group. LC was performed by 66 (94.2%) patients with percutaneous cholecystostomies. Proved highly effective percutaneous cholecystostomy and low risk of complications stage treatment.