[Surgical management of acute cholecystitis in elderly and old age patients].

Results of treatment of 233 old and elderly patients with acute cholecystitis were analysed. In 206 from them percutaneous transhepatic drainage of the gallbladder (PTDGB) was carried out under US control with creation of temporary microcholecystostoma for elimination of acute attack of cholecystitis by decompression of the biliary system, in 2 patients laparoscopic cholecystostomy was performed, and in 27 patients with choledocholithiasis and jaundice early endoscopic papillosphincterotomy was carried out. Elimination of acute attack of cholecystitis in early terms contributed much to improvement of the patients condition, to carrying out further examination and correction of concomitant diseases. After adequate premedication 189 patients were operated on early after admission (on day 2-4). The operation of choice was cholecystectomy, in 49 patients being combined with various interventions on the choledochus. Postoperative mortality rate made up 4.2%. 44 patients were not operated because of elimination of the attack by PTDGB (17) and endoscopic papillosphincterotomy (27).