Surgical strategy and tactics in acute cholecystitis treatment, complicated by bile ducts affection in patients older than 70 years old

The article features a retrospective treatment analysis of 96 patients over 70 years old with destructive cholecystitis and choledocholithiasis. Stage treatment was preferred, using ebdoscopic and minimally-invasive technologies in stage 1 (endoscopic papillosphincterotomy EPST, Ultra-Sound- or laparoscope-assisted cholecystotomy). Surgical intervention was stage 2. 14 patients after cholecystistotomy with high risk cholecyctectomy remaining underwent endoscopic obliteration of cholecyst. Radical surgery through a mini-port was chosen over endoscopic decompression technique in 31 patients with low bilirubin level and absence of severe concomitant pathology. The developed tactics enabled treatment outcome improvement, with mortality rate of 5,2%.