[Acute cholecystitis in combination with chronic hepatitis and cirrhosis of the liver].

An analysis of surgical treatment of cholelithiasis, acute cholecystitis was made which had appeared in 107 patients against the background of chronic diseases of the liver. Current diagnostic methods were used for differential diagnostics of jaundice: USI, CT, retrograde cholecystopancreatography, duodenoscopy. All the patients were operated upon against the background of hepatotropic and anti-ulcer therapy being performed. The main component of anesthesia during operation in most patients was epidural blockade which unlike multicomponent anesthesia had no negative effects on the indices of bilirubin in blood and aminotranspherase activity. Cholecystectomy, sanitation and decompression of bile ducts in patients with acute cholecystitis which appeared against the background of chronic lesion of the liver allowed to eliminate the source of portal toxemia, liquidate the mechanical source of cholestasis that, as a rule, results in liquidation of acute hepatic failure. The optimal method of differential diagnostics of jaundices was intraoperative cholangiography and choledochotomy.