Surgical treatment of cholecystitis

According to domestic and foreign authors, the frequency of gallbladder diseases and surgical interventions for cholecystitis has increased markedly in recent years. Acute cholecystitis currently occupies the second place in urgent abdominal surgery after appendicitis, and in elderly and senile people it is more common. Despite the increase in the number of patients hospitalized as planned for surgical treatment from Therapeutic departments, the majority of patients continue to be admitted urgently with various diagnoses — with acute cholecystitis, exacerbation of chronic cholecystitis, acute hematocholecystitis, cholecystopancreatitis and others. Surgeons are faced with the task of understanding this variety of diagnoses, establishing the true cause of suffering and choosing the most rational treatment tactics. For many years, surgeons have adhered to conservative and wait-and-see tactics in acute cholecystitis. Attempts to activate surgical treatment of acute cholecystitis, equate it with tactics for acute appendicitis led to high postoperative mortality (10-20%) and unsatisfactory long-term results [1-3]. This forced most surgeons to refuse to perform operations at the height of an attack of acute cholecystitis, to consider only the picture of peritonitis as an indication for an emergency operation.