AN ALGORITHM FOR THE DIAGNOSIS AND SURGICAL TREATMENT OF ACUTE CALCULOUS CHOLECYSTITIS IN ELDERLY AND SENILE PATIENTS WITH COMORBIDITIES
The results of a prospective analysis of the data of 50 patients aged 60 to 90 years who were treated in Surgery Research Centre named after M.A. Topchubashov from 2015 to 2018. The study included patients who underwent surgery for acute calculous cholecystitis in patients with diabetes mellitus, obesity and cardiovascular disease. All patients underwent ultrasound, 60% of patients underwent CT and 36% underwent MRT. 36 patients (72%) underwent laparoscopic cholecystectomy (LCE), 14 patients (28%) underwent open cholecystectomy. Open surgeries were divided into 2 groups. In 10 patients (20%) traditional wide access, in 4 patients (8%) open mini-access CE was performed. An algorithm for the diagnosis and surgical treatment of patients with acute destructive calculous cholecystitis is presented. For the purpose of safe cholecystectomy, to prevent iatrogenic injuries, the «bottom» technique of subtotal cholecystectomy is recommended. Iatrogenic the common bile duct injuries was not recorded.