[Peculiarities of clinical features and surgical treatment policy in old patients with acute cholecystitis].

The results of treatment of 138 patients with acute cholecystitis aged from 75 to 89 years are analyzed. Calculous cholecystitis was revealed in 126 patients, acalculous cholecystitis--in 12 patients. Cholelythiasis was revealed in 63 (45.6%), stricture of the large duodenal papilla (LDP)--in 13 (9.4%), combination of choledocholithiasis and stricture of LDP--in 16 (11.6%). Mechanical jaundice was revealed in 54 (39.1%) patients, purulent cholangitis--in 18 (13%). From 138 patients 113 (81.8%) underwent surgery. Urgent operations were carried out in 35 (30.9%), early operations--in 54 (47.8%), delayed operation--in 24 (21.2%) patients. Cholecystectomy was performed in 99 patients, it was supplemented with choledocholithotomy and various types of external drainage of the duct (n = 28), choledochoduodenostomy (in 40), transduodenal papillosphincterotomy (n = 6) and endoscopic papillosphincterotomy (n = 7). Cholecystostomy was carried out in 14 patients (including laparoscopic cholecystostomy, n = 5). Repeated operations were performed in 29 patients. Postoperative complications appeared in 28 (24.7%) patients. 16 patients (14.1%) died after the operation. The causes of death were hepatic functional deficiency (6), peritonitis (2), pancreatic necrosis (1), acute cardio-vascular failure (4), pulmonary artery thrombo-embolism (2), acute cerebro-vascular failure (1).