Optimization of Minimally Invasive Surgical Management of Acute Destructive Cholecystitis Based on Clinical Differentiation of Patients

Relevance. Acute destructive cholecystitis remains one of the most severe forms of gallstone disease, often complicated by gangrene, perforation, or perivesical abscesses. Traditional open cholecystectomy in these patients, especially those with multiple comorbidities, is associated with high rates of postoperative complications and mortality. In this context, the need for a differentiated approach using minimally invasive techniques—such as laparoscopic cholecystectomy and percutaneous cholecystostomy—is increasingly evident. These techniques provide effective infection control while minimizing surgical trauma, especially in high-risk patients.