Etiology of "difficult" laparoscopic cholecystectomy

• Published in: Hirurgija (Moskva) no. 1; p. 61
• Main Authors: Sazhin, V P, Sazhin, I V, Pod''iablonskaia, I A, Karlov, D I, Nuzhdikhin, A V, Aĭvazian, S A
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2016
• Subjects: Cholecystectomy, Laparoscopic - adverse effects; Cholecystectomy, Laparoscopic - methods; Cholecystitis, Acute - pathology; Cholecystitis, Acute - physiopathology; Cholecystitis, Acute - surgery; Female; Gallbladder - pathology; Gallbladder - physiopathology; Gallbladder - surgery; Humans; Inflammation; Intraoperative Complications - diagnosis; Intraoperative Complications - etiology; Intraoperative Period; Male; Middle Aged; Outcome and Process Assessment (Health Care)
• ISSN: 0023-1207
• DOI: 10.17116/hirurgia2016161-66

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. 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. 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. Technical variants of laparoscopic cholecystectomy for various "difficult" intraoperative situations are suggested.