Tactics and Surgical Treatment of Obstructive Jaundice of Different Etiology

V.M. Ratchik, N.V. Prolom, D.V. Orlovskyi, A.N. Burenko

Abstract


In the department of surgery of the digestive organs of State institution «Institute of gastroenterology of National aca-demy of medical sciences of Ukraine» for the period from 2003 to 2013, 567 patients with pathology of the hepatopancreatobiliary zone of different etiology, complicated with obstructive jaundice, underwent surgery. 197 (34.7 %) patients with bilirubinemia more than 200 µmol/l and III degree of liver failure underwent two-stage treatment. Endoscopic (two-step) techniques were applied for the treatment of 143 (25.2 %) patients with choledocholithiasis. One-step minimally invasive interventions — laparoscopic cholecystectomy, external drainage of the common bile duct, lithoextraction, balloon dilatation of the sphincter of Oddi — implemented in 41 (10.4 %) patients. In complications chronic pancreatitis, draining surgeries were performed in 20 (25.6 %) patients and resection-draining — in 39 (50.0 %), with the correction of bile outflow, as well as endoscopic, laparoscopic and minimally invasive puncture-draining operations were carried out. 2 (2.6 %) patients underwent pancreatoduodenectomy by Whipple. Two-stage surgeries were performed in 26 (33.3 %) patients. At tumors of cholangiopancreatoduodenal zone, 18 (30.5 %) patients underwent percutaneous endobiliary reducing interventions followed by radical surgery in 10 (16.9 %) patients.


Keywords


obstructive jaundice; diagnosis; treatment; minimally invasive technologies

References


Десятерик В.І. Діагностика та лікування гострих ускладнень жовчнокам’яної хвороби на тлі механічної жовтяниці / В.І. Десятерик, О.В. Котов, Є.С. Шевченко // Український журнал хірургії. — 2014. — № 1 (24). — С. 140-147.

Механическая желтуха: современные взгляды на проблему диагностики и хирургического лечения / Ю.А. Пархисенко, А.И. Жданов, В.Ю. Пархисенко, Р.С. Калашник // Український журнал хірургії. — 2013. — № 3 (22). — С. 202-211.

Славин Л.Е. Лапароскопическая холецистэктомия / Л.Е. Славин // Практическая медицина. — 2010. — № 41. — С. 30-35.

Мини-инвазивная хирургия осложненных форм холедохолитиаза / М.Е. Нечитайло, П.В. Огородник, А.Г. Дейниченко и др. // Харківська хірургічна школа. — 2013. — № 2 (59). — С. 12-17.

Freeman M.L. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study / M.L. Freeman, J.A. DiSario, D.B. Nelson et al. // Gastrointest. Endosc. — 2001. — № 54. — P. 425-434.

Fujita N. Endoscopic sphincterotomy and endoscopic pa-pillary balloon dilatation for bile duct stones: a prospective randomized controlled multicenter trial / N. Fujita, H. Maguchi, Y. Komatsu et al. // Gastrointest. Endosc. — 2003. — № 57. — P. 151-155.

Baron T.H. Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: a metaanalysis of rando-mized, controlled trials / T.H. Baron, G.C. Harewood // Am. J. Gastroenterol. — 2004. — № 99. — P. 1455-1460.

Дооперационная диагностика скрытого холедохолитиаза / Т.Б. Ардасенов, Д.А. Фрейдович, А.Г. Паньков и др. // Анналы хирургической гепатологии. — 2011. — № 16 (2). — С. 18-24.

Ничитайло М.Е. Минимально инвазивная хирургия патологии желчных протоков / М.Е. Ничитайло, В.В. Грубник. — М., 2005. — 424 с.




DOI: https://doi.org/10.22141/2308-2097.4.54.2014.82051

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 GASTROENTEROLOGY

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2017

 

 Яндекс.МетрикаSeo анализ сайта Рейтинг@Mail.ru