Modern surgical treatment of elderly patients with choledocholithiasis and mechanical jaundice

A prospective analysis of diagnosis and treatment of the elderly and senile patients with acute cholecystitis complicated by choledocholithiasis and mechanical jaundice is carried out. Ultrasound scan, multispiral computed tomography, MRI and endoscopic retrograde cholangiopancreaography were used in complex diagnosis. The tactics of a double step-by-step approach in surgical treatment of these patients was performed, the first stage required minimally invasive methods of decompression of bile ducts, including endoscopic. The second stage was preferably carried out by minimally invasive surgical operation. The duration of pre-operative preparation and choice of the method of the operation depended on the morphology of acute cholecystitis and degree of the patient’s physical condition. Due to the double step-by-step stage approach of the surgical tactics in such patients the level of postoperative complications decreased up to 9.1% and postoperative lethality reduced up to 6.8%.

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