[Use of endoscopic and surgical methods in the treatment of patients with acute cholecystitis].

Laparoscopic gallbladder drainage (LGBD) was undertaken to arrest acute inflammation in 121 patients suffering from acute cholecystitis and serious concomitant diseases. Their ages ranged from 30 to 89 years. Cholecystectomy was carried out in 78 patients after complete abatement of the inflammatory process. When the risk of a radical operation was very high treatment was restricted to cleansing of the gallbladder cavity (CGBC). In 9 patients stones were removed from the gallbladder through a cholecystostoma, formed during LGBD, using a choledochoscope. Cleansing cholecystostomy under local anesthesia was conducted in 19 cases. Fifteen patients who were treated by CGBC had choledocholithiasis; they were subjected to endoscopic papillosphincterotomy. The death rate was 1.6%.