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Is the Laparoscopic Surgery Contraindicated in Cases of Complicated Acute Cholecystitis?

I. Setchanov, S. Kovachev, D.D. Ziya, Y. Zinovieva, M. Radionov

Abstract


Тhe curative possibilities for acute cholecystitis could be just conservative treatment, early cholecystectomy up to the 72nd hour, and delayed cholecystectomy after conservative treatment and election of the timing of the surgery. The early laparoscopic cholecystectomy is accepted as a modern `gold standard`. In it, the results, according to the rise of the learning curve, are marked as similar and compatible with these of the elective cholecystectomies. The problem of the curative tactics in the cases of complicated acute cholecystitis remains controversial and there is no consent on the timing and the kind of the intervention. They should be defined according to the patho-morphologic alterations and the kind of the complications found, as well as according to the general state and the co-morbidity of the patient. The opinions on the possibilities for a laparoscopic approach in these cases vary from total denial to absolute enthusiasm as an end in itself. We analyzed retrospectively 54 patients with complicated acute cholecystitis out of a total of 517 operated on for acute cholecystitis in our clinic over a three-year period. The cases were differentiated by gender, age, pathomorphological form of the cholecystitis and by the kind of complications. The applied pre-operatively therapeutic approach in the different forms of complications was inspected. The intraoperative, the early and late post-operative results were analyzed. In conclusion, we accept that in cases with complicated acute cholecystitis the laparoscopic surgery is available and is not an absolute contraindication, but each case should be assessed individually.

Keywords

Keywords: complicated cholecystitits, laparoscopic cholecystectomy




DOI: http://dx.doi.org/10.14748/ssm.v48i0.2235

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About The Authors

I. Setchanov

S. Kovachev

D.D. Ziya

Y. Zinovieva

M. Radionov

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