[Surgical treatment of acute cholecystitis complicated by peritonitis in middle-aged and elderly patients].

Peritonitis is among the severe complications of acute cholocystitis; the authors encountered its generalized forms in 10.9% of the patients who were operated on as being critically ill. Gangrenous or perforating cholecystitis was the most frequent cause of peritonitis. The high postoperative death rate (22.4%) caused among elderly and old-aged patients by generalized peritonitis and the necessity of an emergency operation requires intensive preoperative management and complex postoperative treatment with the application of modern detoxification methods in an intensity care department. In view of the high operative-anesthetic risk in patients of the old-age groups, the authors undertook sparing operations for decompression of the gallbladder in generalized peritonitis with the subsequent performance of a radical sanitizing operation in a postponed or planned order. This allowed the postoperative death rate to be reduced to 7.7% in the recent years.