Abstract:

Aim: was to estimate the expediency of one-time sanation of the gallbladder, performed under ultrasound control in patients with acute cholecystitis as a preoperative preparation.

Material and methods. For the period 2007-2016, 1365 sanations of the gallbladder were performed in 1289 patients with acute cholecystitis. In 1284 cases (94.1%), the manipulation was single-staged, performed under local anesthesia by echo-puncture needles, caliber of 17.5 G under ultrasound control by the "free hand" method or using a program of biopsy cursor, percutaneously transhepatic. Access was made through the hepatic parenchyma with a thickness of at least 10 mm. Results. Sanation of the gallbladder was effective in all 1365 cases. Repeated sanitation in a day was necessary in 76 patients. Cholecystectomy within the current hospitalization was performed ir 1132 of (87.8%) 1289 patients, in terms from 1 to 4 days after initial manipulation. The dislocation of the blocking gall-stone from the cervical region of the gallbladder into its lumen was made with a rigid 0.035" gidewire in order to restore cystic duct flow was effective in 122 cases (35.2%). Complications: subcapsular hematomas of the liver in the puncture zone - 4 (0.3%), bilomus of the gallbladder bed - 1 (0.07%), bleeding to the gallbladder lumen - 11 (0.8%) were treated conservatively. There were no lethal outcomes.

Conclusion: one-time sanation of gallbladder allows to decompress safely the gallbladder, to stop pain syndrome, to conduct a full pre-examination and preoperative preparation of patient and perform cholecystectomy in the most comfortable and safe conditions in a delayed or planned order. 

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