[Change in the amylase activity and microflora in the bile in cholecystitis].

To ground the surgical technic and pathognomic postoperative management some etiopathogenetic problems of acute cholecystitis have been studied. The gallbladder contents and abdominal cavity exudate and their effect upon the amylase activity and microflora have been analyzed. The analysis has shown that in the pathogenesis of acute cholecystitis in elderly and senile patients the fermentative component plays an important part, which results in a rapid destruction of the gallbladder against the background of vascular disorders. Such cases need an earlier decompression of the biliary tract and the postoperative management should be aimed at the suppression of pancreatic secretion. As to the majority of the cases of acute cholecystitis, which not infrequently possesses some features of a longlasting chronic process, the operation should be postponed till inflammatory manifestations subside.