Assessment of Complications in Surgical Interventions in Patients with Destructive Cholecystitis and Gallstone Disease

This study presents data on complications resulting from surgical interventions in patients with destructive cholecystitis and gallstone disease using both conventional cholecystectomy and laparoscopic cholecystectomy techniques. The traditional method was employed in the treatment of 488 patients, while the laparoscopic approach was used in 114 cases. In 97.8% of cases, the postoperative diagnosis confirmed a phlegmonous-gangrenous nature of the inflammatory process in the gallbladder tissue. The findings indicate that the rate of intraoperative complications in both types of interventions is approximately the same — 3.26% and 3.48%, respectively. These complications were mainly associated with intraoperative bleeding from the cystic artery and gallbladder bed, injuries to the common bile duct, pulmonary artery branch thromboembolism, cardiovascular insufficiency, and myocardial infarction. The intraoperative mortality rate was identical in both groups — 0.87%. Postoperative complications occurred in 12.84% of patients who underwent conventional cholecystectomy and in 12.21% of patients who underwent laparoscopic cholecystectomy. The most common complications after traditional surgery were bile leakage, wound infection, biliary peritonitis, obstructive jaundice, and bleeding. In laparoscopic cholecystectomy, complications were primarily associated with bile leakage and wound infection. Thus, in cases of destructive cholecystitis, the predominant surgical approach remains traditional cholecystectomy due to the necessity for emergency surgery and the severity of the inflammatory process. When all stages of surgical intervention are properly implemented, a significant number of complications can be avoided.