SURGICAL TREATMENT OF BILE PERITONITIS AS A COMPLICATION OF ACUTE DESTRUCTIVE CHOLECYSTITIS

Objective: Improving the results of surgical treatment of bile peritonitis in patients with cholelithiasis Methods: 2001-2020 5849 patients with cholelithiasis were operated, including 1167 (19.9%) with acute destructive cholecystitis. At the same time, the frequency of acute destructive cholecystitis in the analyzed time periods was 19.2% (394 patients - 2001-2010) and 20.3% (773 patients - 2011- 2020) of the total number of operated patients with cholelithiasis. ), i.e. roughly equal. At the same time, the frequency of operated patients with peritonitis 8.4% (33) and 6.3% (49) as a complication of acute destructive cholecystitis significantly decreased - a total of 82 (7.1%) patients Results: Optimization of the tactical and technical aspects of surgical treatment of patients with bile peritonitis using puncture diapeutics, laparoscopy and transduodenal endoscopic interventions improved the results of treatment in the main study group, where complications in the immediate postoperative period were 16.3%, mortality was 4.1% (in the comparison group - 33.3% and 6.1%, respectively). Conclusions: Biliary peritonitis as a complication of acute destructive cholecystitis was 7.1% and most often (35.2%) developed in elderly patients. According to the mechanism of development in 67.1% was observed flowing bile peritonitis with no pathognomonic signs of a catastrophe in the abdominal cavity.

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