International Medical Journal, Vol. 22., Iss. 3, 2016, P. 16−19.
THE EXPERIENCE OF PERCUTANEOUS TRANSHEPATIC ENDOBILIARY INTERVENTIONS IN PATIENTS WITH CHOLEDOCHOLITHIASIS
Kharkiv National Medical University
V. T. Zaytsev Institute of General and Emergency Surgery, Kharkiv, Ukraine
The article reports the original experience of treatment of patients with choledocholithiasis, who were performed percutaneous transhepatic endobiliary interventions at the so−called "endoscopically complex forms" of choledocholithiasis. The classical surgical interventions performed in the conditions of obstructive jaundice and purulent cholangitis significantly aggravate surgical results and are accompanied by a high level of mortality. Percutaneous transhepatic endobiliary interventions were used in patients to prepare them for reconstructive operations and in a small number of patients after decompression of the biliary tract (mechanical lithotripsy, balloon dilation of the major duodenal papilla and bringing down the stones into the duodenum). If suppurative cholangitis was present, percutaneous transhepatic endobiliary drainage allowed carrying out treatment of the biliary tract with antiseptic solutions. After reconstructive operations, endobiliary drainage was not removed thus preventing the development of biliary hypertension. Percutaneous transhepatic endobiliary interventions can eliminate the obstructive jaundice syndrome, suppurative cholangitis, and prepare the patients to reconstructive surgery and in some cases become the sole method of treatment of patients with high operational and anesthetic risk.
Key words: choledocholithiasis, obstructive jaundice, percutaneous transhepatic endobiliary interventions, reconstructive−restorative interventions.