LAPAROSCOPIC CHOLECYSTECTOMY AT NON-STANDARD SITUATIONS

Abstract

Since 1996 to 2005 1524 laparoscopic cholecystectomies were done in the cases of the acute and chronic cholecystitis. Non-standard situations were observed at 92 cases (6%) among which 35 patients were with severe adhesive and inflammatory processes in choledochal area, 27 — with Mirizzi syndrome of I and II type, 26 — with choledocholithiasis found intraoperatively and 4 — with choledochal-bowel fistulas. Conversion was done in 17 cases (1.1%). In other cases operation was finished laparoscopically. Authors' opinion, that modeling of technique in difficult (non-standard) laparoscopic cholecystectomies is the important practical task.