MODERN MINIMALLY INVASIVE APPROACHES IN THE SURGICAL TREATMENT OF ACUTE CHOLECYSTITIS

Resume. Gallstone disease remains one of the leading conditions in surgical practice. The study included the results of surgical treatment in 138 patients with acute cholecystitis. All surgical procedures and clinical and diagnostic observations were performed at the Department of General Surgery of the Kashkadarya Regional Multidisciplinary Medical Center during the period from 2022 to 2025. The patients’ ages ranged from 18 to 89 years, with females predominating (84.8%). The diagnosis of acute cholecystitis was established based on clinical presentation, laboratory findings, and instrumental examination data. Laparoscopic cholecystectomy was performed in 25 patients (65.8%) with mild disease (Grade I) and in 13 patients (17.3%) with moderate severity (Grade II). In all cases, intraoperative findings included an enlarged and tense gallbladder, often associated with adhesions to the greater omentum or adjacent organs. In 31.6% of cases, gallbladder puncture with evacuation of 30–50 ml of bile was required. Intraoperative signs of acute obstructive cholecystitis were identified in 47.4% of patients, while phlegmonous cholecystitis with destructive changes of the gallbladder wall was observed in 21% of cases. Standard cholecystectomy was performed in 36 patients, whereas laparoscopic cholecystectomy with choledochal drainage according to Vishnevsky was carried out in 2 patients. The results obtained demonstrate that laparoscopic cholecystectomy is a reliable, safe, and cost-effective method for the surgical treatment of acute cholecystitis. We believe that with a cautious and individualized approach, the use of minimally invasive techniques provides optimal clinical outcomes and reduces the risk of postoperative complications. Keywords: gallstone disease, acute calculous cholecystitis, laparoscopic cholecystectomy, choledochal drainage, rehabilitation.

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