[Phlegmon-exacerbated chronic calculous cholecystitis and its surgical treatment]

A series of 165 patients presenting chronic calculous cholecystitis (CCC), operated in the surgical clinic of the Military Hospital--Plovdiv over the period 1991 through 1994, are analyzed. In twenty patients (10 men and 10 women) the disease a clinical course characterized by phlegmonous-purulent cholecystitis. All patients are subjected to operative management, and in all the clinical diagnosis is confirmed intraoperatively. Empyema of the gallbladder with concrements and purulent secretion is discovered in nine cases, and fragility of the gallbladder wall-in four. The histomorphological study reveals phlegmonously exacerbated CCC in 12 patients, walls totally replaced by granulation tissue--in three, and necrotic mucosa--in five. The early results of operative treatment are estimated as good. The long-term results are likewise very good. The positive effect of treatment is lasting, and persists for many years.