Surgical removal of the gallbladder is indicated in nearly all cases of complicated acute @entity2679 . In the 1990s, laparoscopic cholecystectomy became the method of choice in the treatment of @entity9975 . Due to a large inflammatory reaction in the course of acute @entity32 , a laparoscopic procedure is conducted in technically difficult conditions and entails the risk of complications. THE AIM OF THIS PAPER: The aim of this paper was: 1) to analyze ultrasound images in acute @entity2679 ; 2) to specify the most common causes of conversion from the laparoscopic method to open laparotomy; 3) to determine the degree to which the necessity for such a conversion may be predicted with the help of ultrasound examinations. MATERIAL AND METHODS: In 1993-2011, in the Second Department and Clinic of General, Gastroenterological and Oncological Surgery of the Medical University in Lublin, 5,596 cholecystectomies were performed including 4,105 laparoscopic procedures that constituted 73.4% of all cholecystectomies. Five hundred and forty-two @entity1 (13.2%) were qualified for laparoscopic procedure despite manifesting typical symptoms of acute @entity2679 in ultrasound examination, which comprise: thickening of the gallbladder wall of > 3 mm, inflammatory infiltration in the Calot's triangle region, gallbladder filled with stagnated or purulent contents and mural or intramural effusion. RESULTS: In the group of operated @entity1 , the conversion was necessary in 130 @entity1 , i.e. in 24% of cases in comparison with 3.8% of @entity1 with uncomplicated @entity9975 (without the signs of @entity32 ). The conversion most frequently occurred when the assessment of the anatomical structures of the Calot's triangle was rendered more difficult due to local inflammatory process, mural effusion and thickening of the gallbladder wall of >5 mm. The remaining changes occurred more rarely. CONCLUSIONS: Based on imaging scans, the most common causes of conversion included inflammatory infiltration in the Calot's triangle region, mural effusion and wall thickening to > 5 mm. The classical cholecystectomy in acute @entity2679 should be performed in @entity1 with three major local complications detected on ultrasound examination and in those, who manifest acute clinical symptoms.

Significance of ultrasonography in selecting methods for the treatment of acute XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity9975 :: ('MESH:D041761', 'Disease') :: ['cholecystolithiasis'] @entity2679 :: ('MESH:D002764', 'Disease') :: ['cholecystitis']
@entity2679 :: (MESH:D002764,Disease) :: ['cholecystitis']
