| Summary: | Objective. To determine the optimal timing of laparoscopic cholecystectomy in acute calculous cholecystitis with peripancreatic infiltrate.
Materials and methods. We analyzed the results of treatment of 80 patients with acute calculous cholecystitis with peripancreatic infiltration in the clinic in the period from 2022 to 2025. The patients' age ranged from 21 to 72 years. There were 50 men (62.5%) and 30 women (37.5%). The duration of the disease was up to 24 hours in 20 (25%), from 25 to 72 hours in 20 (25%), and over 72 hours in 40 (50%) patients. All patients were divided into 2 groups. Group 1 (control) included 50 (62.5%) patients who had been operated on in district hospitals and private city clinics for acute calculous cholecystitis with peripancreatic infiltration before hospitalization in the clinic, Group 2 (main) included 30 (37.5%) patients with acute calculous cholecystitis who were initially hospitalized in the clinic, of whom 20 (66.7%) had peripancreatic infiltration, 10 (33.3%) had mild pancreatitis.
Results. Emergency laparoscopic cholecystectomy was performed in 10 (33.3%) patients with acute calculous cholecystitis in the setting of mild pancreatitis. The postoperative period was uneventful. Patients were discharged on the 2nd – 3rd day after surgery. The condition of 20 (66.7%) patients with acute calculous cholecystitis against the background of peripancreatic infiltration was assessed as severe during hospitalization. Despite intensive care, pain remained in 12 (60%) patients. These patients underwent early laparoscopic cholecystectomy. In 8 patients with acute calculous cholecystitis against the background of peripancreatic infiltrate, preoperative intensive conservative therapy was performed. On the 20th – 25th day, the improvement of the patients' condition made it possible to perform a planned laparoscopic cholecystectomy.
Conclusions. Comparative analysis of the results of laparoscopic cholecystectomy in acute calculous cholecystitis with peripancreatic infiltration and mild pancreatitis shows that delayed laparoscopic cholecystectomy, when the average time of conservative treatment is 20–25 days from the onset of acute calculous cholecystitis, is preferable to early cholecystectomy.
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