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Updated: Aug 10, 2026

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
[Etiology of "difficult" laparoscopic cholecystectomy]
V P Sazhin1, I V Sazhin1, I A Pod''iablonskaia1
1Chair of Surgery with Endosurgical Course, Faculty of Additional Postgraduate Education of acad. I.P. Pavlov Ryazan State Medical University.
Aim:
To define causes of difficult situations in various forms of acute cholecystitis depending on terms of disease and clinico-morphological changes in gall bladder area and to justify differentiated application of laparoscopic surgery for acute cholecystitis.
Material And Methods:
It was reviewed 1132 medical records of patients with acute cholecystitis. It is found that morphological changes in gall bladder and surrounding tissues depend on duration of follow-up of patients with acute cholecystitis and type of inflammation.
Results:
In acute catarrhal cholecystitis "complicated" intraoperative situations are observed in 37.5% due to "loose" tissues infiltration, in phlegmonous and gangrenous forms of inflammation - in 44.6% and 63.6% respectively due to "dense" infiltrates development.
Conclusion:
Technical variants of laparoscopic cholecystectomy for various "difficult" intraoperative situations are suggested.

