[Acute enzymatic cholecystitis: difficulties in diagnosis and surgical treatment].

In analysis of the results of clinical, laparoscopic and intraoperative investigations in 70 patients with acute obstructive, and 68--with acute enzymatic cholecystitis, it was established that for differential diagnosis of acute enzymatic cholecystitis, of most importance were the intractable pain in the right hypochondrium, early appearance of peritoneal symptoms, hyaloid edema of the gallbladder wall and hepatoduodenal ligament, exudate in the subhepatic space with a dash of bile, and detection of the phospholipase activity and high content of malonic dialdehyde in the cystic bile.