Acute cholecystitis (AC) appears as the basic complication of cholelithiasis. However, the leading place in the mortality structure belongs to choledocholithiasis, cholangitis obstructive, jaundice, and especially to infected biliary pancreatic necrosis. Retrospective analysis of the results of investigations and surgical treatment of 1023 patients with complicated forms of cholelithiasis included 314 men and 709 women at the age between 15 and 91 years. Such complications of cholelithiasis as AC, choledocholithiasis, cholangitis and stricture of papilla major are not the contra-indication to laparoscopic cholecystectomy. The treating possibilities of laparoscopic and endoscopic technique in 96.2% cases allowed successfully performing cholecystectomy and the correction of bile outflow without doing the wide laparotomy. Offered technical improvements of laparoscopic cholecystectomy promoted lowering of conversions number (from 8.8% to 3.8%) and the quantity of intra- and post-operative complications contained in the changes of trocat inserting points, using modified instruments for tissue dissection, mobilizing of gall-bladder and hemostasis.

• MeSH
• cholecystektomie laparoskopická MeSH
• cholecystostomie MeSH
• cholelitiáza * chirurgie   komplikace   patofyziologie   MeSH
• dospělí MeSH
• endoskopie metody   využití   MeSH
• laparoskopie metody   využití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sfinkterotomie endoskopická metody   využití   MeSH
• video-asistovaná chirurgie MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) MeSH
• žlučové cesty chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

The clinic, laboratorial, intraoperative, and morphologic findings of 482 patients with acute gangrenous cholecystitis have been studied. There were 162 men (33.6%) and 320 (67.4%) women at the age of 15-91 years, with average 55.3±6.5 years old. 218 patients were operated by laparoscopic method, traditional access was provided in 264 patients. Conversion was performed in 17 from 218 cases (7.8%). Postoperative complications made 8.3% and 13.6% in both groups respectively. Intraoperative complication during laparoscopic cholecystectomy (common bile duct injury) occurred in 1 (0.46%) patient operated at the fifth day since the commencement of disease. Conversions and complications reduction was provided by the offered technical improvements of laparoscopic cholecystectomy such as a change of the points of trocars injection, using the modified instruments for the tissues dissection, gallbladder mobilization and hemostasis.

• MeSH
• akutní cholecystitida * chirurgie   komplikace   patofyziologie   MeSH
• chirurgie operační metody   MeSH
• cholecystektomie laparoskopická * metody   využití   MeSH
• dospělí MeSH
• endoskopie využití   MeSH
• gangréna * etiologie   chirurgie   komplikace   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• peroperační komplikace MeSH
• pooperační komplikace MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH