[Disputable problems of surgical tactics in acute cholecystitis].

On the grounds of literature data and their own experience, the authors came to the conclusion that clear-cut identification of the character of the pathological process is of principal importance in deciding on the time of operative intervention for acute cholecystitis. Patients with a pronounced clinical picture of acute cholecystitis and those with signs of peritonitis must be operated on as emergencies, "postponed" operations produce poor results. Indications for an emergency operation in patients with acute cholecystitis complicated by obstructive jaundice and other conditions must be considered individually. An emergency operation is carried out if there are signs of circumscribed peritonitis, in all other cases detoxication therapy is applied for 2-3 days and is followed by operation. Patients with exacerbation of chronic frequently recurring calculous cholecystitis should be operated on in a planned order.