THE USE OF MINIMALLY INVASIVE METHODS OF TREATMENT OF OBSTRUCTIVE JAUNDICE WITH CALCULOUS ETIOLOGY
Authors:
Type:
Article
Pages:
from 127
to 133
Status:
Published
Received:
28.09.2015
Accepted:
23.03.2017
Published:
15.09.2015
Language:
Russian
Keywords:
choledocholithiasis, drainage, biliary tract, hyperbilirubinemia, cholestasis, "Randevu".
Abstract (English):
The effectiveness of isolated retrograde endoscopic interventions and combined manipulations by the method «Randevu», also surgical operations for the purpose of elimination of choledocholithiasis, complicated by mechanical jaundice was defined on a large clinical material. It was identified a significant decline in hyperbilirubinemia in all used methods of treatment. Liver enzymes alanineaminotransferase and aspartate aminotransferase significantly reduced in the application of minimally invasive retrograde endoscopic and combined manipulations by the method «Randevu». There was a significant decrease in the diameter of the common bile duct by ultrasound only at the use of combined interventions by the method «Randevu». There was the greatest number of complications at the use of surgical methods of treatment of choledocholithiasis, complicated by mechanical jaundice, reaching 20% of cases. The rate of complications at the use of minimally invasive retrograde resolution methods of choledocholithiasis averaged 3% of cases. Postoperative complications are not observed at the use of the combined manipulations by the method "Randevu". Based on the analysis of the above data, the author determines the best treatment outcomes in patients with concomitant minimally invasive operations on the method of «Randevu», manifested a significant decrease in indicators of bilirubi-nemia, hepatic enzymes, diameter of the common bile duct. Also, this two-step tactic can be recommended for the extreme severity of the patient´s state, complicated by obstructive jaundice.
The effectiveness of isolated retrograde endoscopic interventions and combined manipulations by the method «Randevu», also surgical operations for the purpose of elimination of choledocholithiasis, complicated by mechanical jaundice was defined on a large clinical material. It was identified a significant decline in hyperbilirubinemia in all used methods of treatment. Liver enzymes alanineaminotransferase and aspartate aminotransferase significantly reduced in the application of minimally invasive retrograde endoscopic and combined manipulations by the method «Randevu». There was a significant decrease in the diameter of the common bile duct by ultrasound only at the use of combined interventions by the method «Randevu». There was the greatest number of complications at the use of surgical methods of treatment of choledocholithiasis, complicated by mechanical jaundice, reaching 20% of cases. The rate of complications at the use of minimally invasive retrograde resolution methods of choledocholithiasis averaged 3% of cases. Postoperative complications are not observed at the use of the combined manipulations by the method "Randevu". Based on the analysis of the above data, the author determines the best treatment outcomes in patients with concomitant minimally invasive operations on the method of «Randevu», manifested a significant decrease in indicators of bilirubi-nemia, hepatic enzymes, diameter of the common bile duct. Also, this two-step tactic can be recommended for the extreme severity of the patient´s state, complicated by obstructive jaundice.
Keywords:
choledocholithiasis, drainage, biliary tract, hyperbilirubinemia, cholestasis, "Randevu".
choledocholithiasis, drainage, biliary tract, hyperbilirubinemia, cholestasis, "Randevu".
Введение. Желчнокаменная болезнь (ЖКБ) является одной из самых распространенных болезней человека, частота встречаемости данной патологии составляет от 8 до 20% взрослого населения планеты. Частота холедохолитиаза колеблется от 8,1 до 46% больных с желчнокаменной болезнью, более того прослеживается тенденция к его увеличению [10].
Количество операций на желчевыводящих путях, продолжает неуклонно расти с каждым годом, что связано с улучшением диагностики холедохолитиаза, увеличением частоты развития желчнокаменной болезни и ее осложнений. ЖКБ преимуществен-
