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Abstract
Summary. Acute cholecystitis is one of the most frequent urgent pathology – about 10-15 %.
 Purpose of the analysis – to improve the outcomes of the surgical treatment elderly and senile age patients with acute cholecystitis based on ultrasonic method investigation of a perivesical infiltration.
 Materials and method. Clinical investigation and the analysis of results of surgical treatment of acute cholecystitis at 147 patients were carried out. In all cases, cholelithiasis was the cause of acute cholecystitis. Differential criteria of the choice of surgical approach were formed before operation with the ultrasonography of a hepatopancreatoduodenal zone and color mapping with Doppler ultrasonography of a blood-circulation in a wall of a gall bladder. Depending on tissue density and spreading of inflammation, three types of infiltrate were identified: friable infiltrate, dense infiltrate with well-defined contours of a gall bladder and dense infiltrate with blurring of contours of a gall bladder and a choledoch.
 Conclusion. The research revealed the most characteristic signs of ultrasonography mapping based on which already before operation it is possible to identify contraindications to laparoscopic approach. Optimization of the choice of surgical approach allowed to increase safety of operation and to improve its results.
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