Decision on the strategy of treatment of acute cholecystitis in high operative risk patients

: Based on their personal experience with treatment of 118 patients the authors consider that sanitation-decompression percutaneous-transhepatic punctures of the gallbladder under US control can be used for arresting the inflammation process. The integral scales SAPS-II and POSSUM allow identification of groups of patients with high operative risk. The strategy of treatment depends on both the state of the patient and results of USI. The detection of an obturating concrement in the gallbladder neck requires punctures for decompression of the gallbladder and attempts to reestablish normal bile passage in addition to conservative therapy at early terms.