OPTIMIZATION OF TACTICAL AND TECHNICAL ASPECTS OF SURGICAL TREATMENT OF ELDERLY AND SENIOR PATIENTS WITH COMPLICATED FORMS OF CHOLELITHIASIS

The results of treatment of 171 elderly and old patients with complicated cholelithiasis configurations are presented. Factor consideration determined that a larger proportion of mortality, purulent-septic and extra-abdominal complications (Fourteen.8%, 48.1% and 55.6% in accordance with this) in patients of the elderly and the old year were traced after the efforts one-stage constructive surgical correction of intense destructive cholecystitis or obstructive cholangitis. Staged surgical therapy, taking into account the established criteria for scoring the level of severity by the capital of patients, as well as the predictable risk of postoperative complications, together with the use of preparatory minimally invasive decompression interventions in malicious routes performed in 42.2% of patients of the main category, allowed to localize purulent-cholemic intoxication, improve the results of further constructive actions. In 15.6% of patients, these interventions appeared to be the final cure. Improving the tactical and technical nuances of surgical treatment of elderly and old patients with complicated cholelithiasis configurations, taking into account the severity level of patients' capital and the predictable risk of postoperative complications, allowed to significantly reduce mortality, postoperative purulent-septic and extra-abdominal burdens (3.1%, 12 .4% and 29.9% in line with this), while in the matching team, these characteristics collected 8.1%, 32.4% and 41.9%.

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