[The surgical treatment of acute cholecystitis in patients with a high operative risk].

An analysis of 406 observations of acute cholecystitis was made. It was found that 70.9% of the patients were older than 60. All of them had severe coexistent diseases. Emergent operations are considered to be indicated with the presence of localized or diffuse peritonitis. Hemosorption on the day of admittance and a radical operation within 1-2 days are recommended to patients with bile stasis of up to 7 days duration, longer time of bile stasis requires endoscopic papillotomy at the moment of admittance to the hospital and nasobiliary drainage followed by 2-3 sessions of hemosorption and radical operation within 7-9 days. Not effective conservative therapy should be changed by laparoscopic microcholecystostomy. The radical operation should be performed at the cold period.