Bezruchko M. A choice of method surgical treatment of acute cholecystitis for patients with a high operationally-anesthetic risk

Dissertation is sanctified to the improvement of direct and remote results of holiatry of acute cholecystitis for patients with a high operationally-anesthetic risk. In basis of dissertation research, the comparative analysis of results of treatment of 183 patients is fixed with an acute cholecystitis and high operationally-anesthetic risk. It is set on the basis of analysis undertaken studies, which development of operating stress is at application of OCE, LCE and TTD GB under control ultrasound is characterized an increase in the serum of blood level of pregnenetrioldione, prolactin and glucose. It is set at the comparative analysis of the got results, that interference with the least level of operating stress is TTD GB. The analysis treatment of patients this category is in-process conducted with the use of the actively-temporizing surgical tactics accepted in general lines, certain ways of improvement results of their treatment due to application of two stage curative tactics with application I stage of TTD GB under control ultrasound and realization of radical surgical intervention from ІІ by the stage after reduction to the degree of operationally-anesthetic risk. It allowed to decrease frequency of postoperative complications from 64,6% to 20,3% and general lethality from 12,5% to 5,1%. And application of percutaneous catchment under control ultrasound, as to the stage in treatment of patients from paravesical by festering complications of AC, allowed to bring down frequency of postoperative festering-septic complications from 38,5% to 11,4%. Development and introduction in clinical practice of method of treatment of AC with local peritonitis for patients from operationally-anesthetic risk V after classification of ASA, in basis of that there is a complex of the mini-invasion events, sent to the catchment, sanation of GB and subhepatic space with next implementation of chemical mucoclasis of GB, allowed to warn the relapses of AC without application of radical operative intervention.