[Minimally invasive interventions for acute cholecystitis complicated by mechanical jaundice in elderly and senile...

Results of the diagnosis and treatment of 165 patients with acute cholecystitis complicated by mechanical jaundice in elderly and senile age were analyzed. The method of endoscopic retrograde papillocholangiography used in 153 patients with acute cholecystitis complicated by mechanical jaundice is thought to be the most informative method of investigation of the bile ducts which allows determination of the exact cause and the level of disturbance of their patency. In 138 (83.6%) patients the cause of these complications was choledocholithiasis, in 18 (10.9%) isolated scarry strictures of the terminal part of the common bile duct and major duodenal papilla and in 9 patients (5.5%) a combination of these two diseases. Purulent cholangitis developed in 61 patients. Operations were fulfilled in 122 patients at the second stage, in 38 patients it was laparoscopic cholecystectomy. The differentiated medico-diagnostic strategy for acute cholecystitis complicated by mechanical jaundice using a two-stage method of decompression and sanitation of the bile ducts is the most rational method of treatment of elderly and senile patients.