Humam A. Choice of operative intrusion in patients with acute cholecystitis with perivesical complications.

The results of treatment of 440 patients with acute cholecystitis, being in clinical treatment from 2000 to 2012 were presented in the work. All the patients were divided into 2 groups. The first group being the comparison group included 222 patients being in clinic from 2000 to 2005. The second group, being the main one included 218 patients being in clinic from 2006 to 2011. The main method of early diagnostics of mechanical jaundice is USR which allows to define the beginning of the disease on the stage of biliary tract broadening over the bile flow obstacle place before the jaundice syndrome begins.The suggested tactics of terms and volume of operative intrusion choice in patients with acute cholecystitis complicated by perivesical infiltration allowed to lower the number of conversions from 5,4% to 3,3%, complications - from 14,4% to 0%, bed-day - from 38 ± 2,1 to 12 ± 1,6. In patients with acute cholecystitis complicated by perivesical abscess conversions were absent in the main group, complications comprised 2,8%; in the group of comparison conversions were in 32,5% complications - in 29,7%; in patients with Mirizzi syndrome the suggested tactics allowed to run over conversions, complications and mortality which in the group of comparison comprised 19%, 14% and 4,6% consequently.