[The surgical procedure and treatment of paravesical abscesses in acute cholecystitis in middle-aged and elderly patients].

The results of 238 operations performed for acute cholecystitis within 1985-1990 have been analysed. Of them in 11 (4.6%), paravesical (8 cases) and intrahepatic (3) abscesses were revealed. In 8 patients, the presence of an abscess at the preoperative period was supposed. All the patients were admitted to the hospital later than 24 h from the onset of the disease and operated on within 1 to 5 days. Perforation of the gallbladder was revealed in 5 patients, gangrene with destruction of its wall--in 3. Abscess location near the gallbladder fundus was noted in 4 patients, near its neck--in 2, along the medial surface--in 2. A unicameral abscess was revealed in 5 cases, a multicameral one--in 3. The operative treatment presents technical difficulties and consists in performance of cholecystectomy (sometimes--Pribram's mucoclasis), external drainage of the common bile duct and abscess cavity, drainage of the subhepatic and subphrenic space. One 82-year old patient died.