[Surgical treatment of patients with complicated forms of cholelithiasis].

An analysis of surgical treatment of 124 patients with "difficult" gallbladder has shown that in most cases (59.7%) the causes impeding surgical procedures were massive commissural processes in the gallbladder zone and stony infiltrates of the hepato-duodenal ligament with shrunken or sclerosed gallbladder as well as earlier operations on the gallbladder, a combination of echinococcosis and liver cirrhosis with acute calculous cholecystitis, cholecystodigestive fistulas, Mirizzi syndrome and intrahepatic location of the gallbladder. Videolaparoscopic operations in such cases are extremely difficult, so open laparotomic operations should be preferred.