[Relaparotomy in surgery of cholelithiasis]

In a period of 5 years 790 patients underwent operation in the surgical clinic for cholelithiasis. Relaparotomy had to be conducted on 23 (2.9%) patients because intraabdominal complications occurred: escape of bile from the gallbladder bed and choledochus in its drainage, and development of peritonitis in 13 patients, pancreatitis in 2 patients, abdominal abscesses in 5, bleeding into the free abdominal cavity and the gastrointestinal tract in 3 patients. The diagnosis of complications is difficult. The developing symptoms are masked by infusion and antibiotic therapy, injection of narcotics, intestinal paresis. A complex approach is conducive to the establishment of the diagnosis: one doctor in charge, intensive surveillance of the patient, study of the results of laboratory and clinical methods of examination in dynamics. The indications for operation should be considered from the very onset in some cases. Nine (39.1%) patients died after relaparotomy.