[Bilithiasis (cholenephrolithiasis)].

The study covers 232 patients with chronic calculous cholecystitis, operated in the Surgical Clinic of the Military Hospital--Plovdiv over the period 1991 through August 1995. Bilithiasis (cholenephrolithiasis) is diagnosed in 26 cases (11.2 per cent). This is a condition running a clinical course characterized by pain in the right subcostal and lumbosacral regions, accompanied by nausea and vomit in 57.7 per cent. Eighteen patient sustain renal crisis. Palpatorily, pain is established in the right subcostal region, and positive succussio renalis--in twelve patients. In nine patients there is evidence of albuminuria and leukocyturia (34.6 per cent). In 26 cases the echographic study reveals presence of concretions in the gallbladder, and in all of them-renal calculi too (left kidney--9, right kidney--9, and bilaterally--8 patients). Intraoperatively, concretions in the gallbladder are found in all patients, with hydrops and empyema of the gallbladder documented in five, and vesicoduodenal fistula in one (23 per cent), whereas in the patients free of urolithiasis they amount to 10.8 per cent which points to a reciprocal aggravation of the two pathological conditions. The early, as well as the long-term results of the operative management applied are estimated as very good.