Features of acute cholecystitis treatment in elderly and senile patients

Abstract

Acute cholecystitis is the most common urgent abdominal pathology. Cholelithiasis is the cause of the disease in most cases. Approximately half of the patients with acute cholecystitis are elderly and senile. The use of minimally invasive technologies allows performing an adequate amount of surgical intervention with minimal trauma of the operation. The aim of the study – to consider scientific approaches to solving the question of the tactics of surgical intervention in acute cholecystitis in elderly and senile patients. Materials and Methods. The databases Pubmed, medLine, EmBASE, CINAHL, PsycINFO were used, the search included publications until 2020. The studies met the following criterion: studies aimed at identifying the tactics of surgical intervention in acute cholecystitis in elderly and senile patients. Results. The results of recent studies allow us to better understand the tactics of surgical intervention in acute cholecystitis in elderly and senile patients, and also open the way for further research. The most common factors limiting active surgical tactics are the presence of several pathologies in gerontological patients at the same time, as well as late hospitalization. The use of conservative therapy in order to eliminate the inflammatory process and stabilize the concomitant pathology is not always effective, it leads to forced operations against the background of complications and decompensation of systemic diseases. The emergence of new diagnostic and minimally invasive treatment technologies has made it possible to introduce active surgical tactics with short preoperative conservative preparation in gerontological patients. Conclusions. Performing traditional cholecystectomy in patients with acute cholecystitis is associated with a high surgical and anesthetic risk and mortality rates. The use of minimally invasive methods of treatment can reduce the degree of intraoperative and postoperative risk. Taking into account the high level of mortality and frequent complications this direction requires a further study

Keywords

• cholelithiasis
• acute cholecystitis
• elderly and senile patients
• traditional cholecystectomy
• minimally invasive surgical intervention technologies