Experience in the implementation of minilaparotomy cholecystectomy in acute cholecystitis access complicated about cystic infi ltrates

Abstract

In this paper shows the results of treatment of 47 patients with a cloelithiasis, complicated by an acute cholecystitis and paravesical infi ltrate by using atypical ways of a cholecystectomy from minilaparotomy access. Criteria and indications for performance universally recognized cholecystectomy from minilaparotomy access, from a bottom and by Pribram are showed. Rational receptions of operating and tool maintenance of a hemostasis are detailed at minicholecystectomy in the conditions of dense paravesical infi ltrate. It is shown that frequency of conversion at the acute cholecystitis complicated by dense infi ltrate, at performance of atypical ways minicholecystectomy, makes 4,2 % that is statistically authentic more low, than at performance standard minicholecystectomy at which frequency of conversion reaches 15 %. Introduction of atypical ways of minicholecystectomy at destructive forms of the acute cholecystitis complicated by dense paravesical infi ltrate, reduces risk of damage of anatomic formations of a hepatoduodenal ligament, and number of intra and postoperative complications from 12,7 to 2,1 %.